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Neuro-Malloy > Nystagmus > Flashcards

Nystagmus Flashcards

(50 cards)

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1
Q

What does a pendular nystagmus look like?

A

equal movement

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2
Q

What does a jerk nystagmus look like?

A

slow and fast component

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3
Q

True nystagmus is ______ and does not _____.

A

binocular, fatigue

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4
Q

Waveform describes…?

A

The movement of the nystagmus

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5
Q

Amplitude describes?

A

How much movement

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6
Q

Frequency describes ?

A

how many times it’s moving

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7
Q

Nystagmus is named after what phase?

A

The fast phase

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8
Q

When doing DO, the ONH slowly moves down and quickly moves up. What’s the front of the eye doing? What type of nystagmus is this?

A
  • front of the eye slowly moves up and quickly moves down

- downbeat nystagmus

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9
Q

What are the 3 main causes of nystagmus?

A
  1. Infarction
  2. Injury
  3. Demyelination
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10
Q

A congenital nystagmus will have what type of waveform?

A
  1. Horizontal

2. . Jerk or Pendular

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11
Q

A congenital nystagmus in a 1-4mo baby will look like what?

A
  • triangular wave form

- small amps, higher frequency

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12
Q

A congenital nystagmus will look like what at 7-18 mos?

A
  • jerk waveform
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13
Q

Describe the acronymn SLOW FUN for a congenital nystagmus.

A
  1. Symptomless
  2. Latent component
  3. abnormal OKN
  4. mixed Waveform (jerk/pendular)
  5. worse during Fixation
  6. horizontal in Upgaze
  7. better in Null zone
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14
Q

Describe the latent component of a congenital nystagmus.

A

When you cover one eye, the fixating eye will beat away from the covered eye (you’ll notice it on VAs)

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15
Q

Where is the null zone for a congenital nystagmus?

A

Usually convergence

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16
Q

What are the management options for a congenital nystagmus?

A
  • Pt is symptomless, so they don’t think they need to try anything
  • CLs
  • BO prism/-1.00 sphere = puts pt in null zone
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17
Q

What is the triad for Spasmus Nutans?

A
  1. Nystagmus
  2. Head nod
  3. Head tilt
    - but doesn’t always present like this
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18
Q

When does the head not go away?

A

When in supine position and sleeping

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19
Q

What is the waveform for spasmus nutans?

A
  • horizontal
  • vertical
  • torsional
  • pendular
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20
Q

What is the amplitude and frequency for spasmus nutans?

A
  • Low amplitude
  • High frequency
    (small, quick movements)
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21
Q

When is the onset of spasmus nutans? What’s the duration?

Study These Flashcards
A
  • Onset = 4-12 months of age

- Duration = < 12 months (should resolve)

22
Q

When should a patient recover from spasmus nutans? What if they don’t?

Study These Flashcards
A
  • Pt should recover by 2 years old

- If > 2, must perform imaging to check pathology

23
Q

This type of nystagmus occurs when you have someone look to the limit of their gaze. If you bring the gaze in by 30 degrees, it goes away.

Study These Flashcards
A

Physiologic Gaze Evoked Nystagmus

24
Q

What are the horizontal gaze centers?

Study These Flashcards
A
  • CN VI nuclei

- PPRF

25
In a pathologic gaze evoked nystagmus, it is do to ______ force of the muscle tonus.
Unequal force
26
In a pathologic gaze evoked nystagmus, the eye will drift ____ toward the stronger side, and ___ toward the weaker side.
- slowly toward stronger side - fast toward weaker side (fast phase always toward weaker side)
27
If the fast phase of a nystagmus is to the right, what side is weaker?
right gaze center is weaker
28
When nystagmus is asymmetric between right and left gazes, you must think its ______.
pathologic (i.e. more nystagmus found in right gaze than in left)
29
In vestibular nystagmus, the eye will drift _____ toward the weaker side and _____ toward the stronger side.
- slowly toward the weaker side | - fast toward the stronger side
30
In vestibular nystagmus, the fast phase will be _____ from the weaker side.
away
31
In gaze-evoked nystagmus, the fast phase will be _____ the weaker side.
toward
32
What type of vestibular nystagmus presents when the patient has a sudden onset of double vision and vertigo (dizziness) when they woke up in the morning.
Peripheral (vestibular nerve)
33
How long does a peripheral VN last vs. central VN?
- Peripheral = 4 weeks | - Central = forever
34
What is the direction of the VN in peripheral vs .central?
- Peripheral = horizontal and torsional | - Central = anything
35
What type of nystagmus every so often switches direction?
Periodic Alternating Nystagmus
36
What is the waveform of periodic alternating nystagmus?
Reversing, Horizontal, Jerk (not vertical)
37
What is the main cause of periodic alternating nstagmus? Treatment?
- Arnold-Chiari Malformation | - Baclofen
38
Downbeat nystagmus is worse in what gaze?
- worse in downgaze (fast phase is down) | - if chiari malformation = worse in downgaze and lateral gaze
39
What's the tx for downbeat nystagmus?
- base down prism
40
Upbeat nystagmus is worse in what gaze? What's the tx?
- worse in upgaze - fast phase is up - tx w/ base up prism
41
What can make upgaze nystagmus worse that the patient can control?
- tobacco use or smoking
42
What is the waveform for see-saw nystagmus? Amplitude? Frequency?
- WF = Pendular - same speed in both directions - Amp = high (alot of movement) - Freq = low (slow back and forth motion)
43
Where does a lesion localize to that causes see-saw nystagmus?
Interstitial nucleus of cajal (midbrain)
44
In see saw nystagmus, the higher eye ____ and the lower eye ____.
higher eye = intorts | lower eye = extorts
45
What is the best treatment for a see-saw nystagmus? What about other options?
``` Best = Patching one eye Other = BO prism (null point of convergence), sunglasses ```
46
What is the main cause of see-saw nystagmus?
Parasellar and sellar tumors
47
When a patient presents with the roof of the mouth (palate) moving up and down with the same pendular motion as the eyes, what is this called?
Oculopalatal Myoclonus - eyes and tongue will have same movement
48
What is the waveform for oculopalatal nystagmus?
vertical and pendular
49
This type of nystagmus is a very fast, subtle INTORTING motion, not constant.
Superior Oblique Myokemia | - high frequency, low amplitude
50
What is the cause of SO Myokemia? Tx?
CN IV nuclear irritation | Tx with BD prism

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