- 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
- Rapid, uncontrolled, rhythmic oscillation of the eye
- May be horizontal, vertical, and/or rotary
- Optic Nerve Hypoplasia
- Macular Disease
- Neurological damage
- Psychoactive drugs
- Alcohol intoxication
- Head trauma
- Brain tumor
- Multiple sclerosis
- Thalamic hemorrhage
"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.
Stabilize patient and manage primary course of illness. If possible, reverse toxicology.