Titre
Das Heimann-Bielschowsky-Phänomen: eine retrospektive Fallserie und ein Literaturüberblick [The Heimann-Bielschowsky Phenomenon: A Retrospective Case Series and Literature Review]
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Nguyen, A.
Auteure/Auteur
Borruat, F.X.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1439-3999
Statut éditorial
Publié
Date de publication
2019-04
Volume
236
Numéro
4
Première page
438
Dernière page/numéro d’article
441
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
The Heimann-Bielschowsky phenomenon (HBP) is an unusual form of monocular vertical pendular nystagmus and is usually asymptomatic. It always occurs in an eye with longstanding, profound visual loss. Reports of HBP are few and HBP is probably underdiagnosed. Recognition of HBP could prevent unnecessary and potentially harmful investigations. The purpose of this study was to report a series of patients with HBP and to summarise the international literature on the subject in order to better define the clinical presentation of HBP.
The study was approved by the local ethics committee. Medical records of patients diagnosed with HBP and examined by one of us (F. X. B.) were retrieved. Eye movements were quantified, either from video or eye tracking recordings, in all patients. The international literature on HBP was reviewed using the keywords "Heimann-Bielschowsky" or "monocular nystagmus".
From 2007 to 2017, we retrieved seven patients with HBP. In the literature, we found only 8 publications, accounting for 66 cases. In both our cases and those from the literature, VA was worse in the eye with HBP and was usually ≤ 20/200. Visual loss was either congenital or acquired and resulted from a variety of aetiologies. The eye movement was strictly monocular, pendular, mostly vertical, but sometimes oblique. Characteristically, its frequency was irregular but low (0.2 to 2.6 Hz in our cases, 0.05 to 5 Hz in the literature) and its amplitude very variable (1 to 9° and 1.5 to 50°, respectively). Extraocular movements were always preserved.
HBP is a benign monocular eye movement disorder that is always secondary to severe visual loss. Being asymptomatic, HBP is still under-recognised and easily overlooked. Furthermore, both amplitude and frequency of HBP may be small and irregular. Recognition of HBP is mandatory in order to prevent costly, unnecessary, and potentially hazardous investigations, and caution is advised, as cataract surgery might be responsible for postoperative oscillopsia.
The study was approved by the local ethics committee. Medical records of patients diagnosed with HBP and examined by one of us (F. X. B.) were retrieved. Eye movements were quantified, either from video or eye tracking recordings, in all patients. The international literature on HBP was reviewed using the keywords "Heimann-Bielschowsky" or "monocular nystagmus".
From 2007 to 2017, we retrieved seven patients with HBP. In the literature, we found only 8 publications, accounting for 66 cases. In both our cases and those from the literature, VA was worse in the eye with HBP and was usually ≤ 20/200. Visual loss was either congenital or acquired and resulted from a variety of aetiologies. The eye movement was strictly monocular, pendular, mostly vertical, but sometimes oblique. Characteristically, its frequency was irregular but low (0.2 to 2.6 Hz in our cases, 0.05 to 5 Hz in the literature) and its amplitude very variable (1 to 9° and 1.5 to 50°, respectively). Extraocular movements were always preserved.
HBP is a benign monocular eye movement disorder that is always secondary to severe visual loss. Being asymptomatic, HBP is still under-recognised and easily overlooked. Furthermore, both amplitude and frequency of HBP may be small and irregular. Recognition of HBP is mandatory in order to prevent costly, unnecessary, and potentially hazardous investigations, and caution is advised, as cataract surgery might be responsible for postoperative oscillopsia.
PID Serval
serval:BIB_7111CC986905
PMID
Date de création
2019-03-31T13:32:36.326Z
Date de création dans IRIS
2025-05-20T23:31:25Z