Differenzialdiagnose und Therapie des Nystagmus mit pathologischer Schlagform

Lernziele

Der Artikel möchte Interesse wecken an unwillkürlichen Augenbewegungen, die nicht aus einem Rucknystagmus mit einer vestibulär oder optokinetisch induzierten langsamen Phase und einer raschen Rückstellsakkade bestehen, sondern pathologische Schlagformen aufweisen. Diese lassen sich unterteilen in sinusoidale oder elliptoide Pendelnystagmen und sakkadische Oszillationen. Wie beim Rucknystagmus äußern sie sich klinisch in Oszillopsien und Schwindel. Sie können durch die resultierende retinale Bildwanderung den Visus so mindern, dass die Patienten z. B. nicht mehr lesen können. Die Kenntnis dieser Augenbewegungsstörungen vermittelt wichtige Informationen über die Topodiagnostik, die zielgerichtet-rationelle Zusatzdiagnostik, Prognosestellung und Therapie, was ihre Seltenheit relativiert.

Die Arbeit versucht eine Synopsis aus Lehrbüchern [1] [2] [3] [4], einer früheren Arbeit [5] und Medline-Recherchen.

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