What does epileptic nystagmus show us in cases presenting acute neurological symptoms?

•Epileptic nystagmus represents a guide to the lateralization and localization of the lesion in cases presenting with acute neurological symptoms.•The rapid phase of nystagmus is towards the contralateral side of the lesion from which ictal discharges originate.•Ictal discharges are usually caused by the lesion area detected at cranial MRI, or in the neighborhood of this area.•Hyperglycemia should be considered in etiological terms, along with different etiologies affecting the posterior regions of the hemispheres.