Differential Diagnosis for Nystagmus in Children
Single Most Likely Diagnosis
- Congenital Nystagmus: This is the most common cause of nystagmus in children, often presenting in the first few months of life. It is usually benign and may be associated with other conditions such as albinism or congenital cataracts.
Other Likely Diagnoses
- Strabismus: Nystagmus can be a compensatory mechanism for strabismus (crossed eyes), as the brain tries to align the images from each eye.
- Refractive Errors: Uncorrected refractive errors, such as nearsightedness or farsightedness, can cause nystagmus in children.
- Inner Ear Disorders: Conditions like labyrinthitis or vestibular neuritis can cause nystagmus due to the inner ear's role in balance and equilibrium.
- Brainstem or Cerebellar Disorders: Lesions or injuries to the brainstem or cerebellum can result in nystagmus, often accompanied by other neurological symptoms.
Do Not Miss Diagnoses
- Brain Tumors: Although rare, brain tumors, especially those in the posterior fossa (e.g., medulloblastoma), can cause nystagmus and are potentially life-threatening if not diagnosed promptly.
- Multiple Sclerosis: This autoimmune disease can present with nystagmus, among other neurological symptoms, and requires early diagnosis for effective management.
- Wernicke's Encephalopathy: This condition, caused by thiamine deficiency, can lead to nystagmus, ataxia, and confusion, and is potentially fatal if not treated promptly.
Rare Diagnoses
- Ataxia-Telangiectasia: A rare genetic disorder characterized by progressive ataxia, telangiectasias, and immune deficiency, which can also present with nystagmus.
- Pelizaeus-Merzbacher Disease: A rare genetic disorder affecting the central nervous system, leading to nystagmus, ataxia, and spasticity.
- Joubert Syndrome: A rare genetic disorder characterized by nystagmus, ataxia, and developmental delays, often associated with brain malformations.