Oculogyric crises: Etiology, pathophysiology and therapeutic approaches. (March 2017)

• Record Type: Journal Article
• Authors: Barow, Ewgenia; Schneider, Susanne A.; Bhatia, Kailash P.; Ganos, Christos
• Is Part Of: Parkinsonism & related disorders. Volume 36(2017)
• Page Start: 3
• Page End: 9
• Publication Date: 2017-03
• Subjects: Oculogyric crisis -- Dystonia -- Acute dystonic reaction -- Drug-induced dystonia; Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; Movement Disorders -- Periodicals; Nerve Degeneration -- Periodicals; Nervous System Diseases -- Periodicals; Parkinson Disease -- Periodicals; Tremor -- Periodicals; Parkinson, Maladie de -- Périodiques; Parkinson's disease; 616.833
• DOI: 10.1016/j.parkreldis.2016.11.012
• Languages: English
• ISSNs: 1353-8020

Abstract

Abstract: Oculogyric crisis (OGC) describes the clinical phenomenon of sustained dystonic, conjugate and typically upward deviation of the eyes lasting from seconds to hours. It was initially observed in patients with postencephalitic parkinsonism, but since then a number of conditions have been associated with OGC. These include drug-induced reactions, hereditary and sporadic movement disorders, and focal brain lesions. Here, we systematically review the literature and discuss the spectrum of disorders associated with OGC in order to aid clinicians place this rare but distinctive clinical sign into the appropriate diagnostic context. We also provide a brief synthesis of putative pathophysiological mechanisms, as well as therapeutic recommendations based on the literature and our own experience. Highlights: Oculogyric crisis is a rare but characteristic ocular manifestation of dystonia. The spectrum of conditions associated with oculogyric crises is broad. Dopamine-blocking agents are the most common cause of oculogyric crises. Disruption of dopaminergic pathways lies at the core of the pathophysiology. Treatment involves dopaminergic and anticholinergic agents.