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Importance of taking into account pre-existing nystagmus when calculating induced nystagmus. (Vestibulology Clinic).


A 27-year-old woman came to the office with a history of intermittent dizziness
1. a disturbed sense of relationship to space; a sensation of unsteadiness and a feeling of movement within the head; lightheadedness; dysequilibrium.
2. erroneous synonym for vertigo.


diz·zi·ness (d
 beginning 10 years earlier. She described her first spell as a rotary feeling, and it was accompanied by a headache that was diagnosed as migraine. Her spells resolved but then returned 1 year prior to her Visit. Of her current dizziness, she said she experienced two types. She described one type of episode as "things feeling bad and everything out of focus in a jerky way." During the second type, she experienced spells of her entire body and head spinning. The spinning would remain constant for long periods of time, and it would intensify near the time of her menses menses /men·ses/ (men´sez) the monthly flow of blood from the female genital tract.

men·ses (mns
. She reported no tinnitus or hearing loss, but she did complain of constant aural aural /au·ral/ (aw´r'l)
1. auditory (1).
2. pertaining to an aura.


au·ral 1 (ôr
 fullness on the right.

Her electronystagmography electronystagmography /elec·tro·nys·tag·mog·ra·phy/ (-nis?tag-mog´rah-fe) electroencephalographic recordings of eye movements that provide objective documentation of induced and spontaneous nystagmus
aural nystagmus  vestibular n.
caloric nystagmus  rotatory nystagmus induced by irrigating the ears with warm or cold water or air; see caloric test, under test.
Cheyne's nystagmus , Cheyne-Stokes nystagmus a peculiar rhythmical eye movement.
.

e·lec·tro·nys·tag·mog·ra·phy (
 tracings illustrated the importance of taking into consideration preexisting nystagmus when calculating the response induced by the caloric caloric /ca·lo·ric/ (kah-lor´ik) pertaining to heat or to calories.

ca·lor·ic (k-lôr
 stimulus. She exhibited the same left-beating nystagmus while supine supine /su·pine/ (soo´pin) lying with the face upward, or on the dorsal surface.

su·pine (s-pn
 with both the 0[degrees] and 30[degrees] positions, as well as before and after caloric stimulation. Her nystagmus was also present when she would lie on her left side. When calculating the induced nystagmus, there was no significant reduced vestibular response, but there was a48% directional preponderance. These findings were confirmed on simultaneous binaural binaural /bi·nau·ral/ (bi-naw´r'l) pertaining to both ears.

bin·au·ral (b-nôr
 bithermal testing, which elicited a type 4 response and a right-beating nystagmus. Directional preponderance during electronystagmography with the eyes closed is abnormal, and it has no value in identifying a central or peripheral origin of symptoms.

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Article Details
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Author:Brookler, Kenneth H.
Publication:Ear, Nose and Throat Journal
Article Type:Brief Article
Date:Jul 1, 2003
Words:267
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