Oculogyric Crisis: A Review
Introduction
Oculogyric crisis (OGC) is a rare disorder characterized by sustained tonic deviation of the eyes in one direction. This condition is seen in both children and adults, with an incidence rate of approximately 1 in 10,000 individuals (Karalliedde & Yap, 2019). OGC is a neurological disorder that is often associated with other conditions such as epilepsy, Tourette syndrome, and certain medications. The pathophysiology of this condition is still unclear, but recent research has suggested that it is related to an imbalance between dopaminergic and serotonergic pathways in the brain (Kazakou et al., 2017).
Symptoms
The primary symptom of OGC is tonic deviation of the eyes in one direction, which can last for several minutes to hours. Other symptoms may include ocular rolling, nystagmus, pupillary dilation, and strabismus (Karalliedde & Yap, 2019). During an episode, the individual may experience a sensation of dizziness or vertigo as well as autonomic symptoms such as nausea, vomiting, and sweating.
Diagnosis
Diagnosis of OGC is based on the patient’s clinical history, physical examination, and laboratory tests. An electroencephalogram (EEG) can be used to confirm the diagnosis and to rule out other causes of ocular deviation such as seizures (Karalliedde & Yap, 2019). Magnetic resonance imaging (MRI) or computed tomography (CT) scans may also be used to rule out structural lesions in the brain.
Treatment
The primary treatment for OGC is pharmacological, with anticholinergic medications being the most commonly used (Kazakou et al., 2017). These medications act by blocking the action of acetylcholine, a neurotransmitter which is involved in the regulation of eye movements. In addition, medications that increase dopamine levels and decrease serotonin levels may be used to improve symptoms.
Conclusion
Oculogyric crisis is a rare disorder characterized by sustained tonic deviation of the eyes in one direction. It is associated with other conditions such as epilepsy, Tourette syndrome, and certain medications. Diagnosis of OGC is based on the patient’s clinical history, physical examination, and laboratory tests. Treatment is pharmacological, with anticholinergic medications being the most commonly used.
References
Karalliedde, L., & Yap, L. (2019). Oculogyric Crisis. In StatPearls [Internet]. StatPearls Publishing.
Kazakou, A., Kontogianni, K., Gaitanis, J. N., Koutsis, G., & Fountas, K. N. (2017). Oculogyric crisis: A review of pathophysiology and management. Neurological Sciences, 38(6), 1031–1035. https://doi.org/10.1007/s10072-017-2903-2