Which of the following is true?

Question

A patient with a history of seizure disorder and on several seizure medications says a friend noted “jumping eye movements.” The patient describes a sensation of movement at rest since his medications were adjusted upward following a breakthrough seizure several weeks ago. On examination you note that the eyes both slowly move to the right and then quickly jump to the left.

A) This is called nystagmus to the left
B) This is called saccadic eye movement
C) This represents a subclinical seizure
D) This most likely has an ominous cause

Answer 1

A) This is called nystagmus to the left

Nystagmus is named for the fast component, in this case, toward the left. Nystagmus is common with several seizure medications and in this case is likely due to the recent increase in medications rather than a more ominous cause. Saccadic eye movements are similar to nystagmus but represent fixations on apparently moving objects, like watching roadside trees from a moving vehicle. A subclinical seizure with bilateral findings and no effect on consciousness would be unusual.