Types of Nystagmus Due to Stroke vs Vestibular Neuritis Causing Persistent Dizziness or Vertigo
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Published 2024-07-25
One of the first things to quickly and easily check for is something called nystagmus, or involuntary repetitive eye twitching. To evaluate for nystagmus, have the patient move the eyes in all the cardinal directions: left, right, up, and down.
Normally, nystagmus should be absent. However, if nystagmus is present, note which direction the eye is beating towards. The direction of nystagmus is defined by the direction of the quick phase.
An inner ear or vestibular cause for dizziness is suggested if the nystagmus is horizontal and the direction remains the same regardless of which direction the eye is looking.
A neurologic cause for dizziness is suggested if the nystagmus changes direction with eye movement. Neurologic cause for dizziness is also suggested if vertical or torsional nystagmus is present in any eye position.
Of course, if nystagmus is absent in a dizzy patient, it does not eliminate either a neurologic or vestibular cause for dizziness.
But, when this test is combined with a head impulse and skew test, diagnosing a stroke can be as accurate as an MRI scan! Of note, the type of stroke this test identifies is a cerebellar stroke which accounts for only 2% of all strokes.
Head Impulse Test: • Head Impulse Test to Check for Vestib...
Skew Test: • Skew Test to Evaluate Dizziness Due t...
HINTs Test: • HINTs Exam for Acute Vestibular Syndr...
Video created by Dr. Christopher Chang:
www.FauquierENT.net/
Actor Credit:
MJ Gordon @marinjayden
Certified Yoga Alliance Instructor (RYP500, RPYT, Yin)
Certified Fitness Instructor NCEP
www.MJ-Gordon.com/
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All Comments (4)
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Please Note! The info in this video ONLY applies if the dizziness has been CONTINUOUSLY present for hour(s) even when still. If the dizziness is triggered by movement, and disappears when still, you may have BPPV instead and information in this video does NOT apply! Head Impulse Test: https://youtu.be/B09sz3prKBI Skew Test: https://youtu.be/CdnQNUarZr8 HINTs Test: https://youtu.be/iIgezzbbFgg
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How did Amy simulate nystagmus? Very convincing!
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I have a vistabular injury my nerve is disconnected. I’ve been in therapy since 2021. I was told nobody can help me. Therapy is all that helps.
