GAZE EVOKED NYSTAGMUS
LESIONS
CEREBELLAR LESION
IPSILATERAL
ACUTE VESTIBULAR LESION
CONTRALATERAL
VERMIS PYRAMID
UVULA/TONSIL
FLOCCULAR NODULAR LOBE
ANTERIOR VERMIS
NEURAL INTEGRATOR
MEDIAL VESTIBULAR NUCLEUS
NUCLEUS PREPOSITUS HYPOGLOSSI
DISORDERS
SCA1/SCA3/SCA6
PHENYTOIN TOXICITY
UPBEAT NYSTAGMUS
WERNICKE
RECURRENT VOMITING
POOR ORAL INTAKE
ARSENIC POISONING
DRINKING WELL WATER
HYPOMAGNESAEMIA
COFACTOR FOR B1 DEPENDENT ENZYMES
METRONIDAZOLE TOXICITY
VIT B1 DEFICIENCY
GAD AB
UPBEAT/ DOWNBEAT NYSTAGMUS
HODGKIN LYMPHOMA
TR-ANTIBODIES
ALTERNATING DBN AND UBM IN SUPINE POSITION
SEE SAW NYSTAGMUS
CHIASMAL LESION
PERIODIC ALTERNATING NYSTAGMUS
ATAXIA TELENGIECTASIA
DOWNBEAT NYSTAGMUS
MOST PROMINENT IN LATERAL AND DOWN POSITION. FLOCCULUS OR NODULUS LESION
DBN PROMINENT IN LATERAL GAZE IS TYPICAL OF CEREBELLAR DISORDER
IDIOPATHIC (30%)
LITHIUM TOXICITY
LAMOTRIGINE TOXICITY
PHENYTOIN TOXICITY
AMIODARONE TOXICITY
MULTIPLE SCLEROSIS
EA2/ SCA6 (CACNAIA)
FGF14 MUTATION
ALSO CAUSE SCA27
SCA27 CAN HAVE UPBEAT NYSTAGMUS
PARANEOPLASTIC
DOWNBEAT NYSTAGMUS ON LATERAL GAZE
ANTERIOR SEMICIRCULAR CANAL BPPV
DOWNBEAT NYSTAGMUS ON SUPINE
ARNOLD CHIARI MALFORMATION
DOWNBEAT NYSTAGMUS INCREASE ON VALSALVA
GAD AB
UPBEAT/ DOWNBEAT NYSTAGMUS
CELIAC DISEASE
DOWNBEAT NYSTAGMUS (RARE)
ONE CASE OF ATAXIA, SPASTICITY WITH DBN
HODGKIN LYMPHOMA
TR-ANTIBODIES
ALTERNATING DBN AND UBM IN SUPINE POSITION
DBN TREATMENT RX:
4- AMINOPYRIDINE 10 BID
CONTRAINDICATED IF GFR <50 DUE TO SEIZURE RISK
CHLORZOXAZONE (MUSCLE RELAXANT)
ALL NYSTAGMUS RX:
BENZODIAZEPINE
GABAPENTIN
MEMANTINE
OTHER
NYSTAGMUS NORMAL EAR
MENIERE’S DISEASE
WRONG WAY NYSTAGMUS
CONVERGENCE-RETRACTION NYSTAGMUS
ELICITED ON UPGAZE
OR OKN DOWNWARD DIRECTION
NO SLOW COMPONENT
DORSAL MIDBRAIN LESION
REBOUND NYSTAGMUS
FRIEDREICH'S ATAXIA
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PENDULAR NYSTAGMUS (PN)
LOCALIZATION:
LESION IN GUILLAIN MOLLARET TRIANGLE
LESION OF NEURAL INTEGRATOR (MVN/NPH/INC)
GAZE HOLDING PROBLEM
DEMYELINATION DISORDERS
PELIZAEUS MERZBACHER DISEASE
ALEXANDER DISEASE (GFAP)
PEROXISOMAL DISORDERS
TOLUENE POISONING
MULTIPLE SCLEROSIS
INTERNUCLEAR OPHTHALMOPLEGIA
PENDULAR NYSTAGMUS
OSCILLOPSIA
SACCADE AND PURSUIT ABNORMALITIES
XGAZE HOLDING ABNORMALITIES
OPED (LEIGH)
OTHER CAUSES
VISION LOSS
SARCOIDOSIS
SPASMUS NUTANS
HEAD TITUBATION
TO CANCEL PENDULAR NYSTAGMUS
PHENYTOIN TOXICITY
WHIPPLE'S DISEASE
PENDULAR NYSTAGMUS RX:
GABAPENTIN
MEMANTINE