Nystagmus

Question 1

What is nystagmus?

The direction it can go in - 3

What waveforms can you have?

Answer 1

Back and forth movement of the eye

Horizontal
Vertical
Torsional

Pendular
Jerk
Square wave jerk
Complex

Look up to see how they look like!!!

Question 2

Are they uni/bilateral?

Answer 2

Bilateral usually

Question 3

Pathological nystagmus:

It can be congenital or acquired!!!

What causes acquired nystagmus?

Answer 3

Vestibular lesion

Question 4

Congenital nystagmus:

It is usually non-pathological!!!

What does nystagmus early in life indicate?

Answer 4

Sensory deprivation nystagmus (aniridia, blindness)

Space-occupying lesion

Question 5

How should nystagmus be examined?

Answer 5

In primary position (looking ahead)

On directional gaze

Question 6

Jerk nystagmus:

Look up how it looks

Gaze-evoked nystagmus - what does this mean?

Central vestibular nystagmus :
- This has no specific pattern. This is caused by what type of lesion?

Peripheral vestibular nystagmus:

• What is it associated with?
• Causes?

Vertical nystagmus:
- What causes this?

Answer 6

Jerk is towards the direction of the gaze - moves towards the side of the lesion

Brainstem lesion - MS, stroke, tumour

Tinnitus
Deafness

Labyrinthitis
Meniere’s
BPPV

Antiepileptics
Wernicke’s encephalopathy

Question 7

Pendular nystagmus:

Causes - 2

Answer 7

Demyelination

Toxicity

Question 8

Non-pathological nystagmus:

What is end-point nystagmus?

What is optokinetic nystagmus?

Answer 8

Jerk at extreme of gaze in the same direction

Jerk following moving objects (e.g. on train)