What illnesses can cause someone to roll their eyes upward (expose the whites of the eyes)?
Oct 28, 2022
Source: Cainiu Health
Dr. Chen You
Introduction
Rolling of the eyes may be caused by epilepsy, oculomotor paralysis, or should also raise suspicion for acute cerebrovascular disease. It is recommended that patients maintain a light diet, avoid spicy and irritating foods, ensure adequate rest, avoid staying up late, engage in appropriate exercise, and maintain a positive and optimistic mindset, all of which contribute to overall health.
Rolling the eyes upward (exposing the whites of the eyes) could be a sign of epilepsy, but it might also result from oculomotor paralysis or acute cerebrovascular disease. If a patient frequently and uncontrollably rolls their eyes, it is recommended to seek timely medical evaluation at a hospital's ophthalmology department for diagnosis by a qualified physician.
1. Epilepsy
Epilepsy is caused by abnormal, highly synchronized discharges of neurons in the brain, characterized by stiffness, episodic attacks, repetition, and brevity. Patients may suddenly lose consciousness, experience convulsions in limbs, rolling of the eyes, foaming at the mouth, fecal incontinence, tongue biting, and other symptoms. Treatment typically follows medical guidance using antiepileptic drugs; surgical intervention is often reserved for refractory epilepsy.
2. Ocular Muscle Paralysis (Ophthalmoplegia)
Due to weakened immunity, bacterial growth and local infections may occur. When inflammation spreads and affects the nerves around the eyes, it can lead to nerve damage and induce ocular muscle paralysis. As a result, patients may exhibit upward rolling of the eyes when blinking. Common accompanying symptoms include blurred vision and dizziness. Treatment may include medications such as compound neostigmine taurine eye drops or cefixime dispersible tablets, used according to medical advice.
3. Acute Cerebrovascular Disease
Acute cerebrovascular conditions such as acute cerebral infarction or intracerebral hemorrhage, especially when involving areas like the temporal lobe, may present with seizures as an initial symptom. Patients may experience fainting, impaired consciousness, limb convulsions, and rolling of the eyes. For cerebral hemorrhage, treatment—conservative or surgical—is determined based on the volume of bleeding. For ischemic stroke, thrombolytic therapy with urokinase or alteplase can be administered within 4.5 hours of onset; patients beyond this window may receive antiplatelet agents, circulation-improving drugs, and vasodilating medications.
Patients are advised to maintain a light diet, avoid spicy and irritating foods, ensure adequate rest, avoid staying up late, engage in appropriate physical activity, and maintain a positive and optimistic mindset, all of which contribute to better overall health.
