GAZE EVOKED NYSTAGMUS
LESIONS
CEREBELLAR LESION
IPSILATERAL
ACUTE VESTIBULAR LESION
CONTRALATERAL
VERMIS PYRAMID
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UVULA/TONSIL
FLOCCULAR NODULAR LOBE
ANTERIOR VERMIS
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NEURAL INTEGRATOR
MEDIAL VESTIBULAR NUCLEUS
NUCLEUS PREPOSITUS HYPOGLOSSI
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DISORDERS
SCA1/SCA3/SCA6
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PHENYTOIN TOXICITY
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UPBEAT NYSTAGMUS
WERNICKE
RECURRENT VOMITING
POOR ORAL INTAKE
ARSENIC POISONING
DRINKING WELL WATER
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HYPOMAGNESAEMIA
COFACTOR FOR B1 DEPENDENT ENZYMES
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METRONIDAZOLE TOXICITY
VIT B1 DEFICIENCY
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GAD AB
UPBEAT/ DOWNBEAT NYSTAGMUS
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HODGKIN LYMPHOMA
TR-ANTIBODIES
ALTERNATING DBN AND UBM IN SUPINE POSITION
SEE SAW NYSTAGMUS
CHIASMAL LESION
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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
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LAMOTRIGINE TOXICITY
PHENYTOIN TOXICITY
AMIODARONE TOXICITY
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MULTIPLE SCLEROSIS
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EA2/ SCA6 (CACNAIA)
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FGF14 MUTATION
ALSO CAUSE SCA27
SCA27 CAN HAVE UPBEAT NYSTAGMUS
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PARANEOPLASTIC
DOWNBEAT NYSTAGMUS ON LATERAL GAZE
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ANTERIOR SEMICIRCULAR CANAL BPPV
DOWNBEAT NYSTAGMUS ON SUPINE
ARNOLD CHIARI MALFORMATION
DOWNBEAT NYSTAGMUS INCREASE ON VALSALVA
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GAD AB
UPBEAT/ DOWNBEAT NYSTAGMUS
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CELIAC DISEASE
DOWNBEAT NYSTAGMUS (RARE)
ONE CASE OF ATAXIA, SPASTICITY WITH DBN
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HODGKIN LYMPHOMA
TR-ANTIBODIES
ALTERNATING DBN AND UBM IN SUPINE POSITION
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DBN TREATMENT RX:
4- AMINOPYRIDINE 10 BID
CONTRAINDICATED IF GFR <50 DUE TO SEIZURE RISK
CHLORZOXAZONE (MUSCLE RELAXANT)
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ALL NYSTAGMUS RX:
BENZODIAZEPINE
GABAPENTIN
MEMANTINE
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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
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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
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DEMYELINATION DISORDERS
PELIZAEUS MERZBACHER DISEASE
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ALEXANDER DISEASE (GFAP)
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PEROXISOMAL DISORDERS
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TOLUENE POISONING
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MULTIPLE SCLEROSIS
INTERNUCLEAR OPHTHALMOPLEGIA
PENDULAR NYSTAGMUS
OSCILLOPSIA
SACCADE AND PURSUIT ABNORMALITIES
XGAZE HOLDING ABNORMALITIES
OPED (LEIGH)
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OTHER CAUSES
VISION LOSS
SARCOIDOSIS
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SPASMUS NUTANS
HEAD TITUBATION
TO CANCEL PENDULAR NYSTAGMUS
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PHENYTOIN TOXICITY
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WHIPPLE'S DISEASE
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PENDULAR NYSTAGMUS RX:
GABAPENTIN
MEMANTINE
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