Difference between revisions of "Nystagmus"

(Evaluation)
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==Background==
 
==Background==
 +
*Nystagmus = involuntary eye movement
 
*The semicircular canals of the vestibules and the extraocular muscles of the eye function together physiologically to help control gaze locked when the head is in motion
 
*The semicircular canals of the vestibules and the extraocular muscles of the eye function together physiologically to help control gaze locked when the head is in motion
 
*Nystagmus is an aberration in this stabilization of the ocular muscles when in motion
 
*Nystagmus is an aberration in this stabilization of the ocular muscles when in motion
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==Differential Diagnosis==
 
==Differential Diagnosis==
 
===Congenital Nystagmus===
 
===Congenital Nystagmus===
* Optic Nerve Hypoplasia
+
*Optic nerve hypoplasia
* Macular Disease
+
*Macular disease
 +
*Noonan syndrome
  
 
===Acquired Nystagmus===
 
===Acquired Nystagmus===
* Neurological damage
+
*[[Head trauma]], [[tympanic membrane rupture]]
* Psychoactive drugs
+
*[[Brain tumor]]
* [[Alcohol intoxication]]
+
*[[Stroke]]
* [[Head trauma]]
+
*Chiari malformation
* Brain tumor
+
*[[Meniere's disease]], [[BPPV]], [[labyrinthitis]], [[Vestibular Neuritis]]
* [[Stroke]]
+
*[[Multiple sclerosis]]
* [[Multiple sclerosis]]
+
*[[Wernicke–Korsakoff syndrome]], [[thiamine deficiency]]
* Thalamic hemorrhage
+
*Tox causes:
 +
**[[Alcohol intoxication]], [[benzodiazepines]], [[barbiturates]], [[GHB]]
 +
*[[Ketamine]], [[Phencyclidine]]
 +
*[[Amphetamines]], [[MDMA]]
 +
*[[Marijuana]]
 +
*[[Lithium]]
 +
*[[Phenytoin]], [[fosphenytoin]], [[carbamazepine]], [[oxcarbazepine]], [[lacosamide]], [[gabapentin]]
 +
*[[Salicylates]], [[NSAID toxicity]]
  
 
==Evaluation==
 
==Evaluation==
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==Management==
 
==Management==
Stabilize patient and manage primary course of illness. If possible, reverse toxicology.
+
Stabilize patient and manage primary cause of illness.
  
 
==Disposition==
 
==Disposition==
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==See Also==
 
==See Also==
 
+
*[[Focal neurologic deficits]]
  
 
==External Links==
 
==External Links==
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<references/>
 
<references/>
  
[[Category:Symptoms]]
+
[[Category:Symptoms]] [[Category:Neurology]]

Revision as of 01:44, 26 February 2017

Background

  • Nystagmus = involuntary eye movement
  • The semicircular canals of the vestibules and the extraocular muscles of the eye function together physiologically to help control gaze locked when the head is in motion
  • Nystagmus is an aberration in this stabilization of the ocular muscles when in motion

Clinical Features

  • Rapid, uncontrolled, rhythmic oscillation of the eye
  • May be horizontal, vertical, and/or rotary

Differential Diagnosis

Congenital Nystagmus

  • Optic nerve hypoplasia
  • Macular disease
  • Noonan syndrome

Acquired Nystagmus

Evaluation

"H in space" Test

  • Trace H in space

Caloric Reflex Test (also known as Vestibular Caloric Stimulation)

  • The best clinical test for the Vestibulo-Optic reflex
  • Water irrigated into the external auditory canal will exaggerate nystagmus if present
  • Temperature of the irrigated water will control the direction.
    • Cold water will exaggerate a nystagmus to move contralaterally
    • Warm water will exaggerate a nystagmus to move ipsilaterally

COWS: Cold Opposite, Warm Same.

Management

Stabilize patient and manage primary cause of illness.

Disposition

See Also

External Links

References