See-saw nystagmus due to unilateral mesodiencephalic lesion

J Clin Neuroophthalmol. 1991 Jun;11(2):79-84.


See-saw nystagmus is a unique torsional-vertical eye movement disorder with a characteristic appearance. It is a pendular nystagmus with two distinct components: a conjugate torsional component and a disjunctive vertical component. In those cases of see-saw nystagmus in which a focal lesion has been identified, the lesion is usually a bilateral, symmetric lesion located at the mesodiencephalic junction. We report an unusual case of see-saw nystagmus which was due to a strictly unilateral mesodiencephalic lesion. Furthermore, the see-saw nystagmus had, in this case, a jerk wave-form rather than the usual pendular wave-form, with the torsional component of the jerk see-saw nystagmus beating toward the side of the lesion. These observations have an impact upon the localizing and lateralizing significance of torsional nystagmus in general and of see-saw nystagmus in particular.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Diencephalon
  • Eye Movements
  • Female
  • Humans
  • Hydrocephalus / diagnostic imaging
  • Magnetic Resonance Imaging
  • Nystagmus, Pathologic / etiology*
  • Thalamic Diseases / complications*
  • Thalamic Diseases / diagnostic imaging
  • Tomography, X-Ray Computed