Nystagmus: Difference between revisions
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==Evaluation== | ==Evaluation== | ||
==="H in space" Test=== | |||
*Trace H in space | |||
===Caloric Reflex Test (also known as Vestibular Caloric Stimulation)=== | |||
*The best clinical test for the Vestibulo-Optic reflex | |||
*Water irrigated into the external auditory canal will exaggerate nystagmus if present | |||
*Temperature of the irrigated water will control the direction. | |||
**Cold water will exaggerate a nystagmus to move contralaterally | |||
**Warm water will exaggerate a nystagmus to move ipsilaterally | |||
<big>'''COWS''': '''C'''old '''O'''pposite, '''W'''arm '''S'''ame.</big> | <big>'''COWS''': '''C'''old '''O'''pposite, '''W'''arm '''S'''ame.</big> | ||
Revision as of 13:27, 18 January 2017
Background
- The semicircular canals of the vestibules and the extraocular muscles of the eye function together physiologically to help control gaze locked when the head is in motion
- Nystagmus is an aberration in this stabilization of the ocular muscles when in motion
Clinical Features
- Rapid, uncontrolled, rhythmic oscillation of the eye
- May be horizontal, vertical, and/or rotary
Differential Diagnosis
Congenital Nystagmus
- Optic Nerve Hypoplasia
- Macular Disease
Acquired Nystagmus
- Neurological damage
- Psychoactive drugs
- Alcohol intoxication
- Head trauma
- Brain tumor
- Stroke
- Multiple sclerosis
- Thalamic hemorrhage
Evaluation
"H in space" Test
- Trace H in space
Caloric Reflex Test (also known as Vestibular Caloric Stimulation)
- The best clinical test for the Vestibulo-Optic reflex
- Water irrigated into the external auditory canal will exaggerate nystagmus if present
- Temperature of the irrigated water will control the direction.
- Cold water will exaggerate a nystagmus to move contralaterally
- Warm water will exaggerate a nystagmus to move ipsilaterally
COWS: Cold Opposite, Warm Same.
Management
Stabilize patient and manage primary course of illness. If possible, reverse toxicology.