scholarly journals Characteristic difference between irritative nystagmus and paralytic nystagmus - Analysis of spontaneous nystagmus and positional nystagmus.

1986 ◽  
Vol 45 (2) ◽  
pp. 91-100
Author(s):  
Kaoru Ishikawa ◽  
Jiro Hozawa ◽  
Shigeki Kamata ◽  
Keiji Fukuoka ◽  
Shuji Ohta ◽  
...  
Keyword(s):  
Spontaneous Nystagmus ◽  
Positional Nystagmus ◽  
Characteristic Difference ◽  
Nystagmus Analysis

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.

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.

Nystagmus characteristics of healthy controls

2020 ◽  
Vol 30 (6) ◽  
pp. 345-352
Author(s):  
Allison S. Young ◽  
Sally M. Rosengren ◽  
Mario D’Souza ◽  
Andrew P. Bradshaw ◽  
Miriam S. Welgampola
Keyword(s):  
Upright Position ◽  
Community Dwelling ◽  
Spontaneous Nystagmus ◽  
Slow Phase ◽  
Healthy Controls ◽  
Positional Nystagmus ◽  
Low Velocity ◽  
Video Oculography ◽  
Significant Difference ◽  
Horizontal Nystagmus

BACKGROUND: Healthy controls exhibit spontaneous and positional nystagmus which needs to be distinguished from pathological nystagmus. OBJECTIVE: Define nystagmus characteristics of healthy controls using portable video-oculography. METHODS: One-hundred and one asymptomatic community-dwelling adults were prospectively recruited. Participants answered questions regarding their audio-vestibular and headache history and were sub-categorized into migraine/non-migraine groups. Portable video-oculography was conducted in the upright, supine, left- and right-lateral positions, using miniature take-home video glasses. RESULTS: Upright position spontaneous nystagmus was found in 30.7% of subjects (slow-phase velocity (SPV)), mean 1.1±2.2 degrees per second (°/s) (range 0.0 – 9.3). Upright position spontaneous nystagmus was horizontal, up-beating or down-beating in 16.7, 7.9 and 5.9% of subjects. Nystagmus in at least one lying position was found in 70.3% of subjects with 56.4% showing nystagmus while supine, and 63.4% in at least one lateral position. While supine, 20.8% of subjects showed up-beating nystagmus, 8.9% showed down-beating, and 26.7% had horizontal nystagmus. In the lateral positions combined, 37.1% displayed horizontal nystagmus on at least one side, while 6.4% showed up-beating, 6.4% showed down-beating. Mean nystagmus SPVs in the supine, right and left lateral positions were 2.2±2.8, 2.7±3.4, and 2.1±3.2°/s. No significant difference was found between migraine and non-migraine groups for nystagmus SPVs, prevalence, vertical vs horizontal fast-phase, or low- vs high-velocity nystagmus (<5 vs > 5°/s). CONCLUSIONS: Healthy controls without a history of spontaneous vertigo show low velocity spontaneous and positional nystagmus, highlighting the importance of interictal nystagmus measures when assessing the acutely symptomatic patient.

Vestibular Pathophysiologic Changes in Experimental Perilymphatic Fistula

1992 ◽  
Vol 101 (7) ◽  
pp. 612-616 ◽  
Author(s):  
Yasuya Nomura ◽  
Yi-Ho Young ◽  
Makoto Hara
Keyword(s):  
Round Window ◽  
Vestibular Function ◽  
Acute Stage ◽  
Spontaneous Nystagmus ◽  
Round Window Membrane ◽  
Caloric Test ◽  
Positional Nystagmus ◽  
Perilymphatic Fistula ◽  
Membrane Changes ◽  
Ice Water

An animal model of experimental perilymphatic fistula (EPLF) was developed in the guinea pig in order to study vestibular pathophysiology. In experimental animals, 4 μL of perilymph was suctioned from one cochlea via the round window membrane. Changes in vestibular function were as follows. 1) During the acute stage (5 hours postoperatively), spontaneous nystagmus directed toward the normal side was noted in 57.4% of the EPLF animals. This lasted less than 24 hours. 2) One week postoperatively, direction-fixed positional nystagmus toward the lesioned ear was present in 22.7% of the EPLF animals, especially when the lesioned ear was positioned inferiorly. 3) With the ice water caloric test, no response was present in 58.1% of the EPLF animals and an irregular response was found in 22.6% of them, 1 week postoperatively. These results tend to indicate that tests of vestibular function may differentiate between patients with Meniere's disease and those with perilymphatic fistula. Histologic findings indicate that a floating labyrinth is the cause of positional nystagmus and caloric irregularity. The absence of caloric responses was associated with collapse of the vestibular labyrinth.

scholarly journals Pseudo-spontaneous nystagmus in patients with geotropic direction-changing positional nystagmus

PLoS ONE ◽  
2018 ◽  
Vol 13 (4) ◽  
pp. e0196019 ◽  
Author(s):  
Seok Min Hong ◽  
Sung Kyun Kim ◽  
Il-seok Park ◽  
Min Gyeong Shim
Keyword(s):  
Spontaneous Nystagmus ◽  
Positional Nystagmus

Spontaneous Positioning and Postural Nystagmus: A Synopsis

1973 ◽  
Vol 82 (6) ◽  
pp. 844-847 ◽  
Author(s):  
Malcolm H. Stroud
Keyword(s):  
Spontaneous Nystagmus ◽  
Oculomotor Control ◽  
Positional Nystagmus

Spontaneous nystagmus when obvious and well marked is a useful indicator of disturbed oculomotor control. Not all cases are due to vestibular disturbance. Some causes are enumerated including congenital, cerebellar and vestibular lesions. Recording artifacts must be excluded. Positioning nystagmus can be physiological. When onset of the nystagmus is delayed or the duration persists considerably beyond completion of the positioning, then the term positional nystagmus is used. Various types and some possible causative mechanisms are briefly mentioned.

Capturing acute vertigo

Neurology ◽  
2019 ◽  
Vol 92 (24) ◽  
pp. e2743-e2753 ◽  
Author(s):  
Allison S. Young ◽  
Corinna Lechner ◽  
Andrew P. Bradshaw ◽  
Hamish G. MacDougall ◽  
Deborah A. Black ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Spontaneous Nystagmus ◽  
Slow Phase ◽  
Vestibular Disorders ◽  
Positional Nystagmus ◽  
Event Monitoring ◽  
Positional Vertigo ◽  
Horizontal Nystagmus ◽  
Vertical Nystagmus ◽  
Paroxysmal Positional Vertigo

ObjectiveTo facilitate the diagnosis of vestibular disorders by patient-initiated capture of ictal nystagmus.MethodsAdults from an Australian neurology outpatient clinic reporting recurrent vertigo were recruited prospectively and taught to self-record spontaneous and positional nystagmus at home while symptomatic, using miniature video-oculography goggles. Consenting patients with ictal videorecordings and a final unblinded clinical diagnosis of Ménière disease (MD), vestibular migraine (VM), or benign paroxysmal positional vertigo (BPPV) were included.ResultsIctal eye videos of 117 patients were analyzed. Of 43 patients with MD, 40 showed high-velocity spontaneous horizontal nystagmus (median slow-phase velocity [SPV] 39.7°/s; 21 showed horizontal nystagmus reversing direction within 12 hours [24 on separate days]). In 44 of 67 patients with VM, spontaneous horizontal (n = 28, 4.9°/s), upbeating (n = 6, 15.5°/s), or downbeating nystagmus (n = 10, 5.1°/s) was observed; 16 showed positional nystagmus only, and 7 had no nystagmus. Spontaneous horizontal nystagmus with SPV >12.05°/s had a sensitivity and specificity of 95.3% and 82.1% for MD (95% confidence interval [CI] 0.84–0.99, 0.71–0.90). Nystagmus direction change within 12 hours was highly specific (95.7%) for MD (95% CI 0.85–0.99). Spontaneous vertical nystagmus was highly specific (93.0%) for VM (95% CI 0.81–0.99). In the 7 patients with BPPV, spontaneous nystagmus was absent or <3°/s. Lying affected-ear down, patients with BPPV demonstrated paroxysmal positional nystagmus. Median time for peak SPV to halve (T50) was 19.0 seconds. Patients with VM and patients with MD demonstrated persistent positional nystagmus (median T50; 93.1 seconds, 213.2 seconds). T50s <47.3 seconds had a sensitivity and specificity of 100% and 77.8% for BPPV (95% CI 0.54–1.00, 0.64–0.88).ConclusionPatient-initiated vestibular event monitoring is feasible and could facilitate rapid and accurate diagnosis of episodic vestibular disorders.

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