Hemi-see-saw nystagmus with superimposed pendular oculopalatal tremor: case report and systematic review

Hemi-see-saw nystagmus (HSSN) is an uncommon subtype, characterized by elevation and intorsion of one eye with contralateral depression and extorsion, typically in a jerk pattern. It is associated with unilateral lesions of the interstitial nucleus of Cajal and the medial longitudinal fasciculus, both of which are involved in the ocular tilt reaction (OTR). Although its association with oculopalatal tremor (OPT) has been described, it is rare.

We performed a systematic review of seven databases on HSSN, extracting data on demographics, etiology, lesion location, oculomotor findings, nystagmus pattern, outcomes, and in addition we presented a representative case.