nystagmus
Table of Contents
nystagmus
see also:
Introduction
- with normal eyesight, while the head rotates about an axis, distant visual images are sustained by rotating eyes in the opposite direction of the respective axis
- the semicircular canals in the vestibule of the ear sense angular acceleration, and send signals to the nuclei for eye movement in the brain.
- a signal is relayed to the extraocular muscles to allow one's gaze to fix on an object as the head moves.
- nystagmus occurs when the semicircular canals are stimulated (eg. by means of the caloric test, or by disease) while the head is stationary.
- the direction of ocular movement is related to the semicircular canal that is being stimulated
- it may be dependent upon the position of the head positional nystagmus such as occurs with BPV
Aetiology
physiologic
- a form of involuntary eye movement that is part of the vestibulo-ocular reflex (VOR), characterized by alternating smooth pursuit in one direction and saccadic movement in the other direction.
- optokinetic - induced by looking at moving visual stimuli
- postrotatory nystagmus - as occurs when one spins in a chair continuously and stops suddenly
hereditary
- uncommon cause
- X-linked infantile nystagmus is associated with mutations of the gene FRMD7
- complete congenital stationary night blindness (CSNB)
- mutations are found in NYX (nyctalopin) on X chromosome
- incomplete CSNB (iCSNB or CSNB-2)
- mutations of CACNA1F on the x chromosome, a voltage-gated calcium channel that, when mutated, does not conduct ions.
infantile
- most often develops by 2 to 3 months of age
- lack of development of normal eye movement control early in life
- albinism
- aniridia
- very high refractive error, for example, nearsightedness (myopia) or astigmatism
- bilateral congenital cataracts
- bilateral optic nerve hypoplasia
- Leber's congenital amaurosis
- optic nerve or macular disease
- persistent tunica vasculosa lentis
- rod monochromatism
spasmus mutans
- usually occurs between 6 months and 3 years of age and improves on its own between 2 and 8 years of age
chronic acquired
- central nervous system diseases
acute acquired
- peripheral inner ear causes
- BPV
- other causes of vertigo - peripheral vs central such as Meniere's, SCDS, labyrinthitis/vestibulitis
- trochlear nerve malfunction
- CNS causes
- stroke
- lateral medullary syndrome
- thalamic haemorrhage
- encephalopathy including Wernicke's
- cerebellar pathology
- abscess
- cerebellar ataxia
- Chiari malformation
- MS
- stroke
- drugs including toxicity
- anticonvulsants such as phenytoin
- pregabalin
- MDMA, PCP
- nitrous oxide
- brain tumours
- sleep deprivation
- exposure to strong magnetic fields eg. MRI
nystagmus.txt · Last modified: 2021/05/22 06:52 by gary1