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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
This tx moves the null point to primary position by adjusting the muscles to eliminate head turn.
Kestenbaum procedure
26
What medication could we use to tx congenital nystagmus?
Botulism, botox
27
What are the 2 types of acquired pendular nystagmus in infancy?
1. Spasmus nutans | 2. See-saw
28
What is the triad of spasmus nutans?
1. Nystagmus 2. Head nodding 3. Anomalous head position
29
What are the characteristics of spasmus nutans?
1. Asymmetric or monocular 2. Strabismus is common 3. Duration 1 to 8 yrs
30
What type of nystagmus is generally associated with spasmus nutans?
Fine, rapid, pendular nystagmus
31
What is the etiology of spasmus nutans?
- benign-delayed development of yoking system | - neurological
32
What are the characteristics of see-saw nystagmus?
One eye elevates and intorts, one eye depresses and extorts
33
What is see-saw nystagmus mainly caused by?
Parasellar tumors
34
What are the 3 types of acquired jerky nystagmus in infancy?
1. Periodic alternating nystagmus 2. downbeat nyst 3. upbeat nystag
35
Periodic alternating nystagmus is mainly caused by what?
- head trauma/encephalitis | - posterior fossa disease
36
Arnold chiari malformation causes what type of nystagmus?
downbeat nystagmus
37
Upbeat nystagmus is usually caused by what?
- Posterior Fossa Disease - Cerebellar disease - Congenital structural medullary lesion
38
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.
Oculomotor dysmetria
39
What 2 things are oculomotor dysmetria caused by?
1. Cerebellar disease | 2. Brainstem tumors
40
This type of nystagmus mimic is horizontal, rapid pendular movement only during fixation. Occurs in burst of a few seconds.
Ocular flutter
41
What 4 things cause ocular flutter?
1. Neuroblastoma 2. hydrocephalus 3. Trauma 4. Drugs (i. e. cerebellar disease)
42
This type of nystagmus mimic is associated with myoclonic jerks of trunks and limbs. It persist with sleep.
Opsoclonus
43
What causes opsoclonus?
1. neuroblastoma | 2. neonatal encephalitis
44
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)
Ocular bobbing
45
What is ocular bobbing caused by?
- Pontine disease (tumor or hemorrhage)
46
This type of nystagmus mimic is found when px is attempting to produce an upward saccade; paralysis of upgaze.
Parinaud's Retraction Nystagmus | - patient will also have LND
47
What causes parinaud's retraction nystagmus?
Pinealoma
48
All nystagmus mimickers are intermittent, which means they are what?
Nystagmoid

Pediatrics (10 decks)

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