Fauquier ENT | Types of Nystagmus Due to Stroke vs Vestibular Neuritis Causing Persistent Dizziness or Vertigo @fauquierent | Uploaded 2 months ago | Updated 2 hours ago
When a patient experiences sudden dizziness that lasts continuously for several hours if not longer, the primary concern is whether the dizziness is due to an inner ear problem or a neurologic issue.
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: youtu.be/B09sz3prKBI
Skew Test: youtu.be/CdnQNUarZr8
HINTs Test: youtu.be/iIgezzbbFgg
Video created by Dr. Christopher Chang:
https://www.FauquierENT.net
Actor Credit:
MJ Gordon @marinjayden
Certified Yoga Alliance Instructor (RYP500, RPYT, Yin)
Certified Fitness Instructor NCEP
https://www.MJ-Gordon.com
Still haven’t subscribed to Fauquier ENT on YouTube? ►► bit.ly/35SazwA
When a patient experiences sudden dizziness that lasts continuously for several hours if not longer, the primary concern is whether the dizziness is due to an inner ear problem or a neurologic issue.
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: youtu.be/B09sz3prKBI
Skew Test: youtu.be/CdnQNUarZr8
HINTs Test: youtu.be/iIgezzbbFgg
Video created by Dr. Christopher Chang:
https://www.FauquierENT.net
Actor Credit:
MJ Gordon @marinjayden
Certified Yoga Alliance Instructor (RYP500, RPYT, Yin)
Certified Fitness Instructor NCEP
https://www.MJ-Gordon.com
Still haven’t subscribed to Fauquier ENT on YouTube? ►► bit.ly/35SazwA
