Overview of nystagmus
- Jason JS Barton, MD, PhD, FRCPC
Jason JS Barton, MD, PhD, FRCPC
- Professor and Canada Research Chair
- Medicine (Neurology), Ophthalmology, and Visual Sciences
- The University of British Columbia
Nystagmus is a rhythmic regular oscillation of the eyes. It may consist of alternating phases of a slow drift in one direction with a corrective quick "jerk" in the opposite direction, or of slow, sinusoidal, "pendular" oscillations to and fro. Jerk nystagmus is more common than pendular nystagmus. (See "Jerk nystagmus" and "Pendular nystagmus".)
Nystagmus can be continuous or paroxysmal, or evoked by certain maneuvers such as specific gaze or head positions. Nystagmus associated with some pathologies may only be seen transiently with hyperventilation or coughing and sneezing.
An overview of nystagmus, its treatment, and the vestibular physiology relevant to nystagmus and vertigo is presented here. The approach to vertigo is discussed separately. (See "Evaluation of the patient with vertigo".)
TYPES OF NYSTAGMUS
The two major types of nystagmus are jerk nystagmus and pendular nystagmus.
Jerk nystagmus — Jerk nystagmus is subdivided by trajectory and the conditions under which it occurs (table 1). Some forms are always present, even when the eyes are in the primary position. Nystagmus in the primary position is classified according to trajectory:
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- TYPES OF NYSTAGMUS
- Jerk nystagmus
- Pendular nystagmus
- BASIC CLINICAL VESTIBULAR PHYSIOLOGY
- The vestibular sensory organs
- Vestibuloocular responses
- Generation of nystagmus
- DIFFERENTIAL DIAGNOSIS
- SYMPTOMATIC THERAPY
- Botulinum injections
- Prism lenses and optical solutions