It may result from the dysfunction of the peripheral (labyrinth, vestibular nerve) or central vestibular pathways (root entry zone of the VIII cranial nerve, brain stem vestibular nuclei to ocular nuclei). The role of imaging is to primarily exclude VIII cranial nerve or brainstem lesion [30]. Spasmus nutans is a rare form of nystagmus that is characterized by a triad of nystagmus, head bobbing, and torticollis. It usually appears at 1 to 3 years of age and abates by 5 to 12 years of age. It usually cannot be easily differentiated from the nystagmus associated with retinal disorders or other lesions caused by anterior visual pathway tumors. Therefore, thorough neuro-ophthalmological and neuroradiological workup with MRI is necessary in these cases [23]. CT Head and Orbits There is no relevant literature to support the use of CT head and orbits in the initial evaluation of children with isolated nystagmus. CT Head There is no relevant literature to support the use of CT head in the initial evaluation of children with isolated nystagmus. Orbital Imaging and Vision Loss-Child CT Orbits There is no relevant literature to support the use of CT orbits in the initial evaluation of children with isolated nystagmus. CTA Head There is no relevant literature to support the use of CTA head in the initial evaluation of children with isolated nystagmus. MRA Head There is no relevant literature to support the use of MRA head in the initial evaluation of children with isolated nystagmus. MRI Head and Orbits MRI head and orbits without or with IV contrast may be helpful as initial imaging in children with isolated nystagmus [27]. Batmanabane et al [29] retrospectively reviewed charts of 148 children who underwent MRI for isolated nystagmus; 23 (15.5%) of these children had abnormal intracranial findings. Most common abnormalities on MRI included abnormal T2 hyperintense signal in white matter (4%), Chiari 1 malformation (3.4%), and optic pathway glioma (2%).
Orbital Imaging and Vision Loss Child. It may result from the dysfunction of the peripheral (labyrinth, vestibular nerve) or central vestibular pathways (root entry zone of the VIII cranial nerve, brain stem vestibular nuclei to ocular nuclei). The role of imaging is to primarily exclude VIII cranial nerve or brainstem lesion [30]. Spasmus nutans is a rare form of nystagmus that is characterized by a triad of nystagmus, head bobbing, and torticollis. It usually appears at 1 to 3 years of age and abates by 5 to 12 years of age. It usually cannot be easily differentiated from the nystagmus associated with retinal disorders or other lesions caused by anterior visual pathway tumors. Therefore, thorough neuro-ophthalmological and neuroradiological workup with MRI is necessary in these cases [23]. CT Head and Orbits There is no relevant literature to support the use of CT head and orbits in the initial evaluation of children with isolated nystagmus. CT Head There is no relevant literature to support the use of CT head in the initial evaluation of children with isolated nystagmus. Orbital Imaging and Vision Loss-Child CT Orbits There is no relevant literature to support the use of CT orbits in the initial evaluation of children with isolated nystagmus. CTA Head There is no relevant literature to support the use of CTA head in the initial evaluation of children with isolated nystagmus. MRA Head There is no relevant literature to support the use of MRA head in the initial evaluation of children with isolated nystagmus. MRI Head and Orbits MRI head and orbits without or with IV contrast may be helpful as initial imaging in children with isolated nystagmus [27]. Batmanabane et al [29] retrospectively reviewed charts of 148 children who underwent MRI for isolated nystagmus; 23 (15.5%) of these children had abnormal intracranial findings. Most common abnormalities on MRI included abnormal T2 hyperintense signal in white matter (4%), Chiari 1 malformation (3.4%), and optic pathway glioma (2%).