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spontaneous nystagmus

Michael Strupp, Thomas Brandt
Vertigo and dizziness are with an annual incidence of more than 10% and a lifetime prevalence of more than 30% among the most frequent symptoms. The keys to the diagnosis are the patient history and the bedside examination: a) for the patient history the time course, type and triggers of symptoms and accompanying symptoms, b) for the clinical examination of the vestibular system the head-impulse test (HIT), the examination for a spontaneous nystagmus, a displacement of subjective visual vertical, a positional nystagmus and the Romberg test, and c) for the differentiation between an acute peripheral and central vestibular lesion the skew deviation, central fixation nystagmus, gaze-evoked nystagmus, saccadic smooth pursuit and a normal HIT...
November 2016: Deutsche Medizinische Wochenschrift
Dimitrios G Balatsouras, George Koukoutsis, Andreas Aspris, Alexandros Fassolis, Antonis Moukos, Nicolas C Economou, Michael Katotomichelakis
OBJECTIVES: We studied the clinical characteristics, nystagmographic findings, and treatment outcome of a group of patients with benign paroxysmal positional vertigo (BPPV) secondary to mild head trauma and compared them with a group of patients with idiopathic BPPV. METHODS: The medical records of 33 patients with BPPV associated with mild head trauma were reviewed. Data of a complete otolaryngological, audiological, neurotologic, and imaging evaluation were available for all patients...
January 2017: Annals of Otology, Rhinology, and Laryngology
Ileok Jung, Seo-Young Choi, Hyo-Jung Kim, Ji-Soo Kim
Even though dizziness is a common symptom of heat illness, comprehensive evaluation of the vestibular function has not been available in this potentially life-threatening disorder. Three patients developed vertigo about a week after heat exposure. Evaluation showed bilateral impairments of the vestibulo-ocular reflex during head impulses and the signs of vestibulocerebellar dysfunction that included spontaneous downbeat nystagmus, gaze-evoked nystagmus, and positional downbeat nystagmus. Exposure to excessive heat may give rise to delayed vestibulopathy by damaging the vestibulocerebellum...
October 20, 2016: Journal of Neurology
Sung-Hee Kim, David S Zee, Sascha du Lac, Hyo Jung Kim, Ji-Soo Kim
OBJECTIVE: To describe the ocular motor abnormalities in 9 patients with a lesion involving the nucleus prepositus hypoglossi (NPH), a key constituent of a vestibular-cerebellar-brainstem neural network that ensures that the eyes are held steady in all positions of gaze. METHODS: We recorded eye movements, including the vestibulo-ocular reflex during head impulses, in patients with vertigo and a lesion involving the NPH. RESULTS: Our patients showed an ipsilesional-beating spontaneous nystagmus, horizontal gaze-evoked nystagmus more intense on looking toward the ipsilesional side, impaired pursuit more to the ipsilesional side, central patterns of head-shaking nystagmus, contralateral eye deviation, and decreased vestibulo-ocular reflex gain during contralesionally directed head impulses...
November 8, 2016: Neurology
Hyun Ji Kim, Dae-Young Kim, Jun Ha Hwang, Kyu-Sung Kim
Objectives: To analyze the clinical characteristics of vestibular neuritis patients with minimal canal paresis (canal paresis <25%). Methods: Patients clinically diagnosed with vestibular neuritis and treated at our institute (n=201) underwent otoneurological examination and vestibular function tests. Patients were categorized in terms of the. Results.: of caloric testing (canal paresis<25%, n=58; canal paresis≥25%, n=143). Clinical characteristics and laboratory outcomes were compared between two groups...
September 27, 2016: Clinical and Experimental Otorhinolaryngology
M Fetter
Sudden unilateral loss of vestibular function is the most severe condition that can occur in the vestibular system. The clinical syndrome is caused by the physiologic properties of the vestibulo-ocular reflex (VOR) arc. In the normal situation, the two peripheral vestibular end organs are connected to a functional unit in coplanar pairs of semicircular canals working in a push-pull mode. "Push-pull" mode means that, when one side is excited, the other side is inhibited, and vice versa due to two mechanisms...
2016: Handbook of Clinical Neurology
Roseli Saraiva Moreira Bittar, Eduardo Setsuo Sato, Douglas Jósimo Silva Ribeiro, Robinson Koji Tsuji
INTRODUCTION: Cochlear implants are undeniably an effective method for the recovery of hearing function in patients with hearing loss. OBJECTIVE: To describe the preoperative vestibular assessment protocol in subjects who will be submitted to cochlear implants. METHODS: Our institutional protocol provides the vestibular diagnosis through six simple tests: Romberg and Fukuda tests, assessment for spontaneous nystagmus, Head Impulse Test, evaluation for Head Shaking Nystagmus and caloric test...
July 31, 2016: Brazilian Journal of Otorhinolaryngology
Masanori Yatomi, Yasuo Ogawa, Mamoru Suzuki, Koji Otsuka, Taro Inagaki, Ujimoto Konomi, Kiyoaki Tsukahara
CONCLUSIONS: The co-existence of cupulolithiasis and canalolithiasis might be a possible mechanism for the spontaneous inversion of positional nystagmus. OBJECTIVE: To investigate the mechanism of spontaneous inversion of nystagmus direction without a positional change in experimental models of co-existing cupulolithiasis and canalolithiasis. METHODS: Co-existing canalolithiasis and cupulolithiasis models were prepared using the bullfrog posterior semicircular canal (PSC)...
August 24, 2016: Acta Oto-laryngologica
Kazumitsu Amari, Yosuke Kudo, Kosuke Watanabe, Masahiro Yamamoto, Koji Takahashi, Osamu Tanaka, Ken Johkura
BACKGROUND AND PURPOSE: Lateral medullary infarction (LMI) sometimes causes long-lasting dizziness. However, the characteristics of nystagmus in patients with post-LMI dizziness are unknown. We undertook a prospective, comparative study of nystagmus in patients with and without post-LMI dizziness to determine the characteristic pattern of nystagmus of chronic post-LMI dizziness. METHODS: We evaluated and compared nystagmus under spontaneous, head-shaking, and positional testing conditions in 12 patients with post-LMI dizziness and in 6 patients without post-LMI dizziness...
September 15, 2016: Journal of the Neurological Sciences
Sertac Yetiser
Different balance problems may occur in the same patient simultaneously, and the other problem may be overlooked if the clinician does not pay much attention. Spontaneous nystagmus of Meniere's disease and positional nystagmus of posterior canal BPPV in the same patient is presented. Positional tests must always be considered even in the presence of spontaneous nystagmus.
July 2016: Clinical Case Reports
Fumiyuki Goto, Miki Arai, Mitusru Kitamura, Tomoko Otomo, Ryoto Nagai, Shuujiro Minami, Takanobu Shimada, Tatsuo Matsunaga, Kouichi Tsunoda, Masato Fujii
INTRODUCTION: The aim of this case report was to investigate the relationship between sleep disorders and audio vestibular symptoms. CASE REPORT: A case of undiagnosed sleep disorder, presenting as a temporary auditory processing difficulty, is presented. The disorder was initially treated as sudden deafness with dizziness. A 23-year-old male patient complained of acute hearing disturbance despite normal results on pure tone audiometry. The patient was initially administered a steroid injection in the hospital...
March 2016: Iranian Journal of Otorhinolaryngology
Kyung-Hwa Jeong, Jung Eun Shin, Dong Hyuk Shin, Chang-Hee Kim
OBJECTIVES: To investigate the incidence and characteristics of direction-reversing nystagmus in patients with horizontal (HSCC) and posterior semicircular canal (PSCC) canalolithiasis, and evaluate the effect of direction-reversing nystagmus on the treatment outcome. STUDY DESIGN: A retrospective study. METHODS: Between March 2014 and September 2015, 63 and 92 consecutive patients with HSCC and PSCC canalolithiasis, respectively, were enrolled...
July 2016: Otology & Neurotology
Yuan Zhao, Taisheng Chen, Wei Wang, Kaixu Xu, Chao Wen, Qiang Liu, Xi Han, Shanshan Li, Xiaojie Li, Peng Lin
OBJECTIVE: To discuss the characteristics of subjective visual gravity (subjective visual vertical/horizontal, SVV/SVH) and assess its clinical application for peripheral unilateral vestibular compensation. METHODS: 69 cases of acute peripheral unilateral vestibular dysfunction patients (case group) accepted SVV/SVH, spontaneous nystagmus (SN), caloric test (CT) and other vestibular function tests. 49 healthy people (control group) accepted SVV/SVH only. SVV/SVH, SN and unilateral weakness (UW) were selected as for the observation indicators...
May 2016: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Brian J Forbes, Donna M McDonald-McGinn, Georgia Wootton, Lindsay Dawson, Elaine Zackai, Gil Binenbaum
We describe the ocular features of the chromosome 22q11.2 duplication syndrome and provide ophthalmologic examination recommendations for affected patients. The medical records of 19 children with chromosome 22q11.2 duplication who had undergone complete ophthalmological examination, including dilated fundus examination and cycloplegic refraction, were studied retrospectively. Over half of the children with 22q11.2 duplication syndrome were found to have visually significant ocular abnormalities, including 6 with strabismus, 2 with moderately high astigmatism requiring glasses, 1 with unilateral congenital cataract requiring surgery, 1 with optic disk drusen, 1 with bilateral megalocornea with normal eye pressures, 1 with nystagmus that resolved spontaneously, and 1 with delayed visual maturation...
June 2016: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Jung Eun Shin, Kyung-Hwa Jeong, Sung Hwan Ahn, Chang-Hee Kim
OBJECTIVE: To demonstrate positional nystagmus during a head-roll test in two patients with lateral semicircular canal (LSCC) cupulolithiasis who presented with spontaneous detachment of otoliths from the LSCC cupula, and to confirm that otoliths may adhere to both the utricle and canal sides of the cupula. PATIENTS AND METHODS: Using video nystagmography, positional nystagmus was evaluated in two patients with LSCC cupulolithiasis who showed the change of nystagmus direction during a head-roll test...
April 18, 2016: Auris, Nasus, Larynx
J H Lee, M S Kim, B R Park
Sensorineural hearing loss, ataxia, pyramidal signs, and vestibular deficits characterize superficial siderosis of the central nervous system. This study investigated changes in vestibular function, free radical formation, and phosphorylated cJun expression in the vestibular end organs after middle ear treatment with a ferric chloride (FeCl3) solution. A single injection of 70% FeCl3solution into the unilateral middle ear cavity caused static vestibular symptoms, such as spontaneous nystagmus and head tilt...
March 27, 2016: Human & Experimental Toxicology
V T Pal'chun, A L Guseva, Yu V Levina, S D Chistov
The objective of the present study was to estimate the prevalence of vertigo and to determine the type of the lesion of the vestibular analyzer in the patients presenting with acute sensorineural loss of hearing (ASNLH). The secondary objective was to evaluate the possibility of the restoration of the auditory thresholds. The results of the examination and treatment of 94 patients suffering from ASNLH are presented. It was shown that the development of acute sensorineural loss of hearing was accompanied by unilateral peripheral vestibulopathy in 22...
2016: Vestnik Otorinolaringologii
Lipin Liang, Tao Chen, Yan Wu
Spinocerebellar Ataxias (SCAs) are a group of autosomal dominantly inherited neurodegenerative diseases, involving the cerebellum and the brainstem. Genetic testing is the most important method of diagnosis. Nowadays, nearly 40 types of SCAs have been identified by genetic analysis. Peripheral nerve impairment is common in SCAs: electrophysiological examination of SCA1, SCA2 and SCA3 usually shows sensorimotor and sensory neuropathy, while pure motor neuropathy is more rare, being seen only in SCA2. The abnormal VEP of SCA1, SCA2 and SCA3 include prolonged P100 latencies and reduced P100 amplitudes...
February 2016: Neurophysiologie Clinique, Clinical Neurophysiology
Sandra Kapitza, Athina Pangalu, Gerhard A Horstmann, Albert T van Eck, Luca Regli, Alexander A Tarnutzer
We discuss a rare acute complication after Gamma Knife therapy (Elekta AB, Stockholm, Sweden) in a single patient. A 52-year-old woman presented with vertigo, facial weakness and hearing loss emerging 48hours following Gamma Knife radiosurgery for a right-sided vestibular schwannoma. Neurological examination 6days after symptom onset showed right-sided facial palsy, spontaneous left-beating nystagmus and pathologic head-impulse testing to the right. Pure-tone audiogram revealed right-sided sensorineural hearing loss...
August 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
M Dawn Nelson, Faith W Akin, Kristal M Riska, Kimberly Andresen, Stephanie Stamps Mondelli
BACKGROUND: The past decade has yielded changes in the education and training of audiologists and technological advancements that have become widely available for clinical balance function testing. It is unclear if recent advancements in vestibular instrumentation or the transition to an AuD degree have affected audiologists' vestibular clinical practice or opinions. PURPOSE: The purpose of this study was to examine predominant opinions and practices for vestibular assessment (VA) and vestibular rehabilitation (VR) over the past decade and between master's- and AuD-level audiologists...
February 2016: Journal of the American Academy of Audiology
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