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Oculogyric crisis is a dystonia that causes extreme fixed eye positions, often due to neurological disorders or medication reactions. Muscle relaxants can help, and stress can trigger episodes. Medical attention should be sought, and long-term treatment may involve changing medications.
Oculogyric crisis is a clinical sign in which a patient’s eyeballs twitch and shift into an extreme fixed position, often looking up or to the side. The patient loses eye control and may develop accompanying symptoms such as drooling, stiff neck and psychological disturbances, depending on the underlying cause. Medications such as muscle relaxants can be given to relax the muscles that control eye movement and allow the eyes to come to a more natural resting position.
This condition is an example of dystonia, in which abnormal muscle contractions cause painful spasms and unwanted movements. Patients with certain neurological disorders such as Parkinson’s disease can develop oculogyric seizures and can also be seen as an adverse reaction to medications, including both prescription drugs and recreational substances. People subjected to extreme stress can also develop dystonias in some cases, and stress is a known trigger for people with a history of oculogyric crises.
Eye movements can vary from patient to patient; they may roll apart, turn inward or more in other ways as the muscles around the eyeball contract and experience tension. An oculogyric crisis can be painful and uncomfortable for the patient. Once it resolves, the patient may show signs of extreme fatigue and usually experience relief from psychological symptoms such as agitation and distress. Emotional distress or another drug exposure can cause the spasms to recur, triggering a new episode.
People around a patient may be disturbed or frightened by the fixed position of the eyes and the patient’s obvious physical discomfort. Remaining calm around the patient, using a neutral, reassuring voice, and making it clear that help is on the way will help reduce the patient’s distress and agitation, even if the patient cannot respond directly during the episode. Stress can prolong an oculogyric seizure episode and can contribute to psychological symptoms such as shouting or acting out.
When a patient’s eyes appear to be moving abnormally or are fixed in a tight position, medical attention should be sought if medical treatment has not already been provided. Dystonias can be a sign of a serious medical problem and may need prompt treatment. A doctor can examine the patient, take a medical history, and prescribe an appropriate treatment to resolve the crisis and make the patient more comfortable. Once the initial problem has been addressed, long-term treatment can be explored, such as changing a patient’s medications to avoid dystonia triggers.
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