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Pediatrics > Nystagmus > Flashcards

Nystagmus Flashcards

1
Q

T/F: A nystagmoid is not rhythmic.

A

True. It’s intermittent, does not occur at regular intervals

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2
Q

What APGAR scores are considered normal?

A

7+ is considered normal

- only goes to 10

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3
Q

Anti-epileptic medications can cause what type of nystagmus?

A

downbeat nystagmus

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4
Q

What does a pendular vs. a jerk nystagmus look like?

A
  • pendular = equal velocity back and forth movement

- jerk = slow and fast phase

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5
Q

The slow drift in a jerk nystagmus means what? What about a fast drift?

A

Slow - pathologic drift

Fast - corrective saccade

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6
Q

This measures the potential difference between the cornea and retina.

A

Electronystagmography

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7
Q

What are the 3 type of congenital nystagmus?

A
  1. Pendular
  2. Jerk
  3. Latent
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8
Q

What are the characteristics of congenital nystagmus?

A

SLO FUN

  • symptomless
  • latent nystag
  • OKN inversion
  • fixation worsens @ dist
  • upgaze never goes to vertical nys
  • null point
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9
Q

What type of nystagmus is apparent upon occlusion of 1 eye?

A

Latent nystagmus

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10
Q

In latent nystagmus, what happens when the right eye is covered? left eye?

A

OD covered = left jerk nystagmus

OS covered = right jerk nystgmus

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11
Q

In latent nystagmus, the slow phase is toward what?

A

The occluded eye

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12
Q

What is the golden characteristic of latent nystagmus?

A
  • direction reversal in each eye

- if lack of reversal = neurological

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13
Q

When performing OKN on a congenital nystagmus px, what are we looking for?

A

OKN inversion

- right jerk nystagmus will nullify or inverse to left jerk nystagmus

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14
Q

Fixation exaggerates the oscillation in congenital nystagmus when viewing where?

A

Distance

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15
Q

If a horizontal nystagmus converts to a vertical nystagmus in upgaze, what is this signifying?

A

Neurological problem

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16
Q

What are the additional characteristics of congenital nystagmus?

A
  1. Bilateral
  2. Symmetric
  3. Disappears w/ sleep
  4. Better near vision
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17
Q

T/F: Congenital pendular nystagmus is almost always horizontal.

A

True

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18
Q

Congenital pendular nystagmus can be converted to what type of nystagmus in extreme gaze?

A

Jerk nystagmus

- it never converts to jerky in upgaze

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19
Q

When is congenital pendular nysgamus usually found?

A
  • 4 wks to 2-3 mo

- not always found at birth

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20
Q

Acquired jerky nystagmus is almost always associated with ______ lesions. When does it usually arise?

A

neurological lesions

- arises after 3 mo of age

21
Q

If the patient converts to vertical jerky nystagmus on up or down gaze, we should assume the lesion is where?

A

Posterior Fossa Lesion

22
Q

This is when the patient was born with a congenital jerk nystagmus, but becomes a bilateral esotrope to keep eyes in null point.

A

Nystagmus blockage syndrome

- nystagmus decreases as ET increases

23
Q

Diencephalic syndrome is usually caused by what?

A

A glioma or astrocytoma located in optic chiasmal region

24
Q

What are the 4 tx of congenital nystagmus?

A
  1. Determine etiology, r/o neurological issue
  2. Kenstenbaum procedure
  3. BO prism
  4. VT, biofeedback
25
Q

This tx moves the null point to primary position by adjusting the muscles to eliminate head turn.

A

Kestenbaum procedure

26
Q

What medication could we use to tx congenital nystagmus?

A

Botulism, botox

27
Q

What are the 2 types of acquired pendular nystagmus in infancy?

A
  1. Spasmus nutans

2. See-saw

28
Q

What is the triad of spasmus nutans?

A
  1. Nystagmus
  2. Head nodding
  3. Anomalous head position
29
Q

What are the characteristics of spasmus nutans?

A
  1. Asymmetric or monocular
  2. Strabismus is common
  3. Duration 1 to 8 yrs
30
Q

What type of nystagmus is generally associated with spasmus nutans?

A

Fine, rapid, pendular nystagmus

31
Q

What is the etiology of spasmus nutans?

A
  • benign-delayed development of yoking system

- neurological

32
Q

What are the characteristics of see-saw nystagmus?

A

One eye elevates and intorts, one eye depresses and extorts

33
Q

What is see-saw nystagmus mainly caused by?

A

Parasellar tumors

34
Q

What are the 3 types of acquired jerky nystagmus in infancy?

A
  1. Periodic alternating nystagmus
  2. downbeat nyst
  3. upbeat nystag
35
Q

Periodic alternating nystagmus is mainly caused by what?

A
  • head trauma/encephalitis

- posterior fossa disease

36
Q

Arnold chiari malformation causes what type of nystagmus?

A

downbeat nystagmus

37
Q

Upbeat nystagmus is usually caused by what?

A
  • Posterior Fossa Disease
  • Cerebellar disease
  • Congenital structural medullary lesion
38
Q

This type of nystagmus mimic is caused by the inability to fixate a target. Px will under or overshoot, followed by to and fro oscillations until target is reached.

A

Oculomotor dysmetria

39
Q

What 2 things are oculomotor dysmetria caused by?

A
  1. Cerebellar disease

2. Brainstem tumors

40
Q

This type of nystagmus mimic is horizontal, rapid pendular movement only during fixation. Occurs in burst of a few seconds.

A

Ocular flutter

41
Q

What 4 things cause ocular flutter?

A
  1. Neuroblastoma
  2. hydrocephalus
  3. Trauma
  4. Drugs
    (i. e. cerebellar disease)
42
Q

This type of nystagmus mimic is associated with myoclonic jerks of trunks and limbs. It persist with sleep.

A

Opsoclonus

43
Q

What causes opsoclonus?

A
  1. neuroblastoma

2. neonatal encephalitis

44
Q

This type of nystagmus mimic is found in patients who are in a como. It presents as an inferior saccade followed by slow return to primary. (downbeat nystagmus)

A

Ocular bobbing

45
Q

What is ocular bobbing caused by?

A
  • Pontine disease (tumor or hemorrhage)
46
Q

This type of nystagmus mimic is found when px is attempting to produce an upward saccade; paralysis of upgaze.

A

Parinaud’s Retraction Nystagmus

- patient will also have LND

47
Q

What causes parinaud’s retraction nystagmus?

A

Pinealoma

48
Q

All nystagmus mimickers are intermittent, which means they are what?

A

Nystagmoid

Pediatrics (10 decks)

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