The Heimann-Bielscholwsky phenomenon: dissociated vertical nystagmus

Abstract

Background: The Heimann-Bielschowsky phenomenon (HBP) is a unilateral vertical nystagmus with coarse, slow pendular movements that typically occurs in an eye with profound visual loss. There are no sinister neurological implications.

Methods: Symptoms and signs on presentation and the subsequent course are described in detail in 10 patients. Eye movements were recorded for one patient.

Results: Three patients had corrected vision of 6/24 or better. Strabismus was seen in eight patients. Symptoms of diplopia and oscillopsia were infrequent.

Conclusions: We believe that the HBP may be a reasonably common condition, although very under diagnosed. This condition may be similar to Central Fusion Disruption. Patients with HBP appear to have lost the potential for fusion.