Nystagmus

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Nystagmus

• slow drift to one side with fast jerk to correct
• direction of nystagmus is direction of fast jerk
• implies posterior fossa or ear disease

Horizontal nystamus to one side

• Ipsilateral cerebellar / brainstem lesion
  • vascular
  • neoplastic
  • demyelinating
  • infective
• Contralateral vestibular lesion
  • peripheral (fatiguable, seen on positional testing)
    • Cochlear dysfunction
      • Labyrinthitis
      • Menières disease
      • Head Injury
    • VIIIth Nerve dysfunction
      • acoustic neuroma
    • Viral neuronitis
  • central (not fatiguable, present at rest)
    • Vestibular nuclei damage
      • vascular
      • neoplastic
      • demyelination
      • drugs
        • phenytoin
        • carbamazepine

Vertical Nystagmus

• Upgaze
  • level of superior colliculus
• Downgaze
  • level of foramen magnum

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