Complete and Immediate Resolution of See-Saw Nystagmus Following Pituitary Macroadenoma Resection: Case Report and Review of the Literature

ABSTRACT

See-saw nystagmus (SSN) is a rare form of nystagmus characterised by alternating elevation with incyclotorsion of one eye and concomitant depression with excyclotorsion of the other eye, often due to abnormalities involving the midbrain and parasellar region. Herein, we highlight a rare case of pendular SSN, which demonstrated complete resolution following resection of a pituitary macroadenoma. A patient in their 40s was identified to have SSN and was diagnosed with a pituitary macroadenoma. They underwent an endoscopic endonasal transsellar approach for resection of the pituitary adenoma. Their nystagmus resolved immediately after surgery. From a review of the literature, resolution and/or significant improvement in SSN occurred in 74% of cases following treatment, with 100%, 86% and 50% following treatment for medication-induced, neurological infarcts, and mass-effect aetiologies of SSN, respectively. SSN is a rare entity with a wide array of aetiologies. Identification of the causative aetiology and appropriate treatment can lead to significant improvement or resolution of the nystagmus in most cases.

KEYWORDS:

• See-saw nystagmus
• acquired jerk nystagmus
• hemi-see-saw nystagmus
• optic chiasm; pituitary macroadenoma

Disclosure statement

No potential conflict of interest was reported by the authors.

Affirmations

Affirmation of compliance with the ethical principles outlined in the Declaration of Helsinki as amended in 2013, affirmation of compliance with HIPAA for the collection and evaluation of protected patient health information.

Supplementary data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/01658107.2023.2299763.

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Funding

The authors reported there is no funding associated with the work featured in this article.