Is Spontaneous Nystagmus a Pathological Sign?

1982 ◽  
Vol 92 (6) ◽  
pp. 618-626 ◽  
Keyword(s):  
Spontaneous Nystagmus ◽  
Pathological Sign

IS SPONTANEOUS NYSTAGMUS A PATHOLOGICAL SIGN?

1982 ◽  
Vol 92 (Sup 6) ◽  
pp. 618???626 ◽  
Author(s):  
Arvind Kumar
Keyword(s):  
Spontaneous Nystagmus ◽  
Pathological Sign

Subjective Evaluation of Balance by the Dizziness Handicap Inventory Does Not Predict Fall Risk in Older Adults Visiting Otolaryngology Clinics

2021 ◽  
pp. 000348942098797
Author(s):  
Iku Abe-Fujisawa ◽  
Yukihide Maeda ◽  
Soshi Takao ◽  
Shin Kariya ◽  
Kazunori Nishizaki
Keyword(s):  
Older Adults ◽  
Postural Balance ◽  
Fall Risk ◽  
Spontaneous Nystagmus ◽  
Anxiety And Depression ◽  
Published Data ◽  
Objective Data ◽  
Subjective Symptoms ◽  
Characteristic Analysis ◽  
Dizziness Handicap Inventory

Objectives: Subjective symptoms of dizziness in older adults are affected not only by objective data such as postural balance, but also by complex psychological factors. Published data analyzing how simultaneous evaluations of both objective and subjective assessments of balance can predict fall risk remain lacking. This study examined how fall risk can be predicted based on both objective data for balance and hearing and subjective symptoms of dizziness among older adults visiting otolaryngology clinics. Methods: Medical charts of 76 patients ≥65 years old with dizziness/vertigo who visited the otolaryngology clinic were reviewed. Objective data were evaluated by postural balance (posturographic data with eyes open and closed, and one-leg standing test), spontaneous nystagmus, and mean hearing levels. Subjective handicap associated with dizziness/vertigo was assessed using the Dizziness Handicap Inventory (DHI). Subjective mental status of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Information on history (cardiovascular diseases) and fall accidents within the preceding year was collected using an in-house interview sheet. Results: Objective data on postural balance did not correlate with subjective symptoms on DHI or HADS ( P > .05, Pearson’s correlation coefficient). Adjusted logistic regression modeling with the outcome of incident falls revealed that poor postural balance significantly predicted fall risk ( P < .05; 4.9 [1.4-16.8] per 10-cm2 increment). Nystagmus tended to be associated with fall risk. In contrast, DHI score did not predict fall risk ( P = .43; 1.0 [0.9-1.03]). Receiver operating characteristic analysis proposed a cut-off for postural sway with eyes closed >6.1 cm2 as optimal to predict falls in patients with nystagmus (AUC, 0.74; 95% confidence interval, 0.48-0.997). Conclusion: Poor postural balance is associated with increased fall risk after adjusting for subjective symptoms in older adults at otolaryngology clinics. Conversely, the self-perceived dizziness handicap of DHI score is an insufficient tool to evaluate their fall risk.

Recovery of subjective visual horizontal after unilateral vestibular deafferentation by intratympanic instillation of gentamicin

2006 ◽  
Vol 16 (1-2) ◽  
pp. 69-73 ◽  
Author(s):  
Yoshinari Takai ◽  
Toshihisa Murofushi ◽  
Munetaka Ushio ◽  
Shinichi Iwasaki
Keyword(s):  
Healthy Subjects ◽  
Time Course ◽  
Early Stage ◽  
Ccd Camera ◽  
The Other ◽  
Spontaneous Nystagmus ◽  
Vestibular Evoked Myogenic Potentials ◽  
Normal Range ◽  
Intratympanic Gentamicin ◽  
Unilateral Vestibular Deafferentation

The time course of the recovery of subjective visual horizontal (SVH) after unilateral vestibular deafferentation by intratympanic instillation of gentamicin was studied. Six patients who underwent intratympanic gentamicin instillation therapy for Meniere's disease (1 man and 5 women, 32 to 69 years of age) were enrolled in this study. For comparison, SVH in 23 healthy subjects (12 men and 11 woman, 23 to 48 years of age) was also measured. The mean ± SD of SVH in healthy subjects was 0.0 ± 1.1 deg. All of the 6 patients showed significantly deviated SVH toward the injected side-down at the early stage after the therapy. Although one patient showed recovery of SVH to the normal range 25 days after the injection, the other patients required more time for recovery. Three patients did not show recovery to the normal range after 1 year. On the other hand, spontaneous nystagmus observed using an infrared CCD camera in total dark disappeared after 35 days (median). Patients who had normal vestibular evoked myogenic potentials before the therapy showed a tendency of delay of recovery of SVH. The reasons why the recovery of SVH took longer than the disappearance of spontaneous nystagmus are discussed in this report.

Spontaneous nystagmus in central nervous disease

1983 ◽  
Vol 8 (4) ◽  
pp. 241-243 ◽  
Author(s):  
K. ZILSTORFF ◽  
S. VESTERHAUGE ◽  
J. TOXMAN
Keyword(s):  
Spontaneous Nystagmus ◽  
Nervous Disease

Asymmetric Optokinetic Afterresponse in Patients with Vestibular Neuritis

1991 ◽  
Vol 1 (3) ◽  
pp. 279-289
Author(s):  
Krister Brantberg ◽  
Måns Magnusson
Keyword(s):  
Vestibular Function ◽  
Vestibular Compensation ◽  
Vestibular Neuritis ◽  
Spontaneous Nystagmus ◽  
Positional Nystagmus ◽  
Optokinetic Afternystagmus ◽  
Vestibular Lesion ◽  
Caloric Response

The symmetry of primary and secondary optokinetic afternystagmus (OKAN I and OKAN II, respectively) was studied in 14 patients with vestibular neuritis, as well as in 50 normals. The patients were examined at onset of symptoms and at follow-up 3 and 12 months later. At onset, OKAN was found mainly to reflect the spontaneous nystagmus. Although the spontaneous nystagmus disappeared in all patients within 3 months, both OKAN I and OKAN II was asymmetric at the 3- and 12-month check-ups. OKAN beating toward the lesioned ear was weaker than the OKAN beating toward the healthy ear. Thus, the asymmetric vestibular function was reflected not only in the OKAN I, but also by an asymmetry in OKAN II. Between the 3- and 12-month check-ups, asymmetry in OKAN declined, even among those patients who showed no improvement in caloric response during that time. The decreasing asymmetry in OKAN with time after lesion was, however, related to the disappearance of a positional nystagmus. Hence, the results may be interpreted as suggesting OKAN not only to be affected by vestibular side-difference, but also to be modified by the process responsible for vestibular compensation following a peripheral vestibular lesion.

Direction-changing spontaneous nystagmus in cerebellopontine angle tumour

2022 ◽  
Vol 95 ◽  
pp. 118-122
Author(s):  
Hamin Jeong ◽  
Dong-Han Lee ◽  
Jung Eun Shin ◽  
Chang-Hee Kim
Keyword(s):  
Cerebellopontine Angle ◽  
Spontaneous Nystagmus ◽  
Cerebellopontine Angle Tumour

scholarly journals 022 Patient-initiated event monitoring for acute vertigo

2019 ◽  
Vol 90 (e7) ◽  
pp. A8.2-A8
Author(s):  
Allison S Young ◽  
Corinna Lechner ◽  
Andrew P Bradshaw ◽  
Hamish G MacDougall ◽  
Deborah A Black ◽  
...  
Keyword(s):  
Spontaneous Nystagmus ◽  
Slow Phase ◽  
Vestibular Disorders ◽  
Positional Nystagmus ◽  
Low Velocity ◽  
Event Monitoring ◽  
Superior Semicircular Canal Dehiscence ◽  
Positional Vertigo ◽  
Horizontal Nystagmus ◽  
Vertical Nystagmus

IntroductionThe diagnosis of vestibular disorders may be facilitated by analysing patient-initiated capture of ictal nystagmus.MethodsAdults with a history of recurrent vertigo were taught to self-record spontaneous and positional-nystagmus at home while symptomatic, using video-goggles. Patients with final diagnoses of disorders presenting with recurrent vertigo were analysed: 121 patients with Ménière’s Disease (MD), Vestibular Migraine (VM), Benign Positional Vertigo (BPV), Episodic Ataxia Type II (EAII), Vestibular Paroxysmia (VP) or Superior Semicircular Canal Dehiscence (SSCD) were included.ResultsOf 43 MD patients, 40 showed high-velocity spontaneous horizontal-nystagmus (median slow-phase velocity (SPV) 39.7 degrees/second (°/s); Twenty-one showed horizontal-nystagmus reversing direction within 12-hours (24 on separate days). In 44 of 67 patients with VM, low velocity spontaneous horizontal (n=28, 4.9°/s), up-beating (n=6, 15.5°/s) or down-beating-nystagmus (n=10, 5.1°/s) was observed; Sixteen showed positional-nystagmus only, and seven had no nystagmus. Spontaneous horizontal-nystagmus with SPV >12.05°/s had a sensitivity and specificity of 95.3% and 82.1% for MD. Nystagmus direction-change within 12-hours was highly specific (95.7%) for MD. Spontaneous vertical-nystagmus was highly specific (93.0%) for VM. In the seven BPV patients, spontaneous-nystagmus was absent or <3°/s, and characteristic paroxysmal positional nystagmus was observed in all cases. Patients with central and MD-related positional vertigo demonstrated persistent nystagmus. Two patients with EAII showed spontaneous vertical nystagmus, one patient with VP showed short bursts of horizontal-torsional nystagmus lasting 5–10s, and one patient with SSCD demonstrated paroxysmal torsional down-beating nystagmus when supine.ConclusionsPatient-initiated vestibular event-monitoring is feasible and could facilitate rapid and accurate diagnosis of episodic vestibular disorders.

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