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Direction-fixed positional nystagmus; spontaneous nystagmus.

Some otolaryngologists would consider these electronystagmography (ENG) tracings to be normal because the nystagmus does not reach 6[degrees]/sec. Unfortunately, this erroneous reasoning has crept into our literature. The misunderstanding is based on a study of subjects without vestibular symptoms, some of whom had almost no caloric nystagmus from one ear and other abnormal findings. With our knowledge of vestibular rehabilitation therapy today, it is clear that an asymptomatic condition can exist within an abnormally functioning vestibular system.

In the tracings above, the nystagmus does not vary more than 1[degrees]/sec from one position to the next. This finding defines spontaneous nystagmus. No matter which position the head is in, the direction and velocity of the nystagmus remain unchanged. This concept avoids defining the "spontaneous" position.

This is an abnormal positional study result, which indicates a vestibular system abnormality of no localizing value as to site (i.e., peripheral or central) or side. This type of abnormality is usually seen in a patient who has a peripheral vestibular disorder of an irritative variety in the left ear. The side is best further deduced from additional ENG information, audiology, history, and neurotologic examination. Turning the neck does not have any effect on the nystagmus in any position.

From Neurotologic Associates, P.C., New York City.
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Author:Brookler, Kenneth H.
Publication:Ear, Nose and Throat Journal
Date:Oct 1, 1999
Words:216
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