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

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.跷跷板样眼球震颤（See-saw nystagmus, SSN）是一种罕见的眼球震颤类型，特征为一眼交替上转伴内旋，另一眼同时下转伴外旋，病因多与中脑及鞍旁区域病变相关。本文报道1例罕见的钟摆型跷跷板样眼球震颤病例，该患者在垂体大腺瘤切除术后眼球震颤完全缓解。一名40余岁患者被确诊为跷跷板样眼球震颤，后续诊断为垂体大腺瘤。患者接受内镜经鼻蝶入路手术切除垂体腺瘤，术后眼球震颤即刻消失。经文献复习，74%接受治疗的跷跷板样眼球震颤患者症状获得缓解或显著改善；其中针对药物诱导性、脑梗死性及占位效应性病因所致的跷跷板样眼球震颤，治疗后症状完全缓解的比例分别为100%、86%及50%。跷跷板样眼球震颤是一类病因多样的罕见病症，明确致病病因并采取恰当治疗，可使大多数患者的眼球震颤症状得到显著改善甚至完全缓解。