This report documents a case of voluntary inhibition of acquired pendular nystagmus after head trauma. A 30-year-old male developed oscillopsia and decreased visual acuity, as well as findings of acquired pendular nystagmus with voluntary inhibition after head trauma. The EOG finding was horizontal 18-20Hz bilateral symmetrical pendular nystagmus in all directions of gaze at near and distant fixation. Nystagmus did not change with 14 Prism Diopter base-out prisms on both eyes, but it was possible to abolish it intentionally. Baclofen and Clonazepam had no effect in improving the patient's symptoms and EOG finding.
Adult ; Case Report ; Electrooculography ; GABA/physiology ; Human ; Male ; Nystagmus, Pathologic/*etiology/physiopathology ; gamma-Aminobutyric Acid/physiology

OBJECTIVE: To study the changes of visual nystagmography(VNG) in patients with vertebrobasilar transient ischemic vertigo(VBTIV), explore their clinical value in diagnosis of the patients with VBTIV. METHOD: Thirty-eight patients who complained vertigo and imbalance with VBTIV were selected as experimental group for testing of visual nystagmography (VNG). Twenty normal persons were chosen as control group. The result was analyzed. RESULT: In the experimental group, there was one case that had spontaneous nystagmus and 29 cases (76.3%) with positional nystagmus. The positional nystagmus intension in those patients was (4.08+/-3.18) degrees/s, which was much higher as compared with the control group( P <0.01). The incidence was 39.5% for positioning test. One or more abnormal findings for visual-oculomotor system examination were shown in 28 patients (73.7%). These abnormal findings included saccade test in 26 cases (68.4%), eye tracking test type III in 13 cases and type IV in 3 cases in all 16 cases (42.1%), optokinetic nystagmus in 17 cases (44.7%). There was none with gaze nystagmus. Caloric test showed canal paresis in 19 cases (50.0%) and directional preponderance in 6 cases (15.9%). In Amount distributing of the general slow phase velocity there is a difference between test group and control group. CONCLUSION Not only vestibular centrum but also peripheral system was involved in patients with VBTIV. These results suggest that VNG be used as important diagnostic test for patients with VBTIV and might be helpful for the location diagnosis of VBTIV.
Adult ; Case-Control Studies ; Electronystagmography ; Female ; Humans ; Male ; Middle Aged ; Nystagmus, Optokinetic ; Nystagmus, Pathologic ; complications ; diagnosis ; Vertebrobasilar Insufficiency ; complications ; physiopathology ; Vertigo ; etiology ; physiopathology ; Vestibular Function Tests

OBJECTIVE: To analyze the value of positioning diagnosis of VNG (Videonystagmograph) in patients with benign paroxysmal positional vertigo (BPPV). METHOD: One hundred and twenty-six patients with BPPV were enrolled in this retrospective study. Their positional nystagmus recorded by VNG in Dix-Hallpike and roll tests were analyzed to summarize the characteristics of nystagmus on nystagmography of various BPPV. RESULT: Of 126 patients with BPPV diagnosed in our center, the posterior semicircular canals (PSC) were involved in 98 patients (77.8%), whereas the horizontal semicircular canal (HSC) and anterior semicircular canal (ASC) were involved in 17 (13.5%) and 5 (3.9%), respectively. Six patients (4.8%) confirmed combined-BPPV had HSC-BPPV and ipsilateral PSC-BPPV. Twenty-eight patients with PSC-BPPV had reversal phase on nystagmography. The nystagmus of patients with P/ASC-canalithiasis showed upward/downward on the vertical phase of nystagmography and orientated the opposite side on horizontal phase in the head hanging position, and the nystagmus reversed when returned to sit. Nystagmus on horizontal phase could be provoked when the head turned to both sides of the roll tests in patients with HSC-BPPV. If the nystagmus and the head-turning shared the same direction, then HSC-canalithiasis was confirmed, and the direction of the head-turning which provoked the stronger nystagmus indicates the lesion side. If the nystagmus and the head-turning had the opposite direction, then HSC-cupulolithiasis was confirmed, and the direction of the head-turning which provoked the weaker nystagmus indicates the lesion side. CONCLUSION Positional nystagmus can be recorded objectively using VNG, According to which positioning the semicircular canal involved would be easier and more accurate. The recording conserved also could be helpful for clinical diagnosis and repositioning of BPPV.
Adolescent ; Adult ; Aged ; Electronystagmography ; Female ; Humans ; Male ; Middle Aged ; Nystagmus, Pathologic ; diagnosis ; etiology ; physiopathology ; Otolithic Membrane ; Retrospective Studies ; Semicircular Canals ; Vertigo ; diagnosis ; physiopathology ; Vestibular Function Tests ; Young Adult

Child, Preschool ; Diagnosis, Differential ; Electroencephalography ; Electroretinography ; Eye Movements ; Head Movements ; Humans ; Infant ; Infant, Newborn ; Nystagmus, Pathologic ; diagnosis ; etiology ; physiopathology ; Retinal Diseases ; diagnosis ; physiopathology ; Risk Factors ; Spasms, Infantile ; diagnosis ; etiology ; physiopathology ; Torticollis ; etiology ; physiopathology