Spontaneous Nystagmus as a Sign of Clinical Significance

Abstract

In the examination of patients suffering from vertigo of loss-of-balance, stress should be put on demonstration and identification of spontaneous nystagmus. the order of applied test-procedures of spontaneous nystagmus is based upon experience gained in examining patients in our clinic.

The applied order is as follows:-

1)examination of spontaneous nystagmus with the eyes open

2)examination of spontaneous nystagmus behind Frenzel's spectacles

3)examination of spontaneous nystagmus by using electronystagmo-graphy

4)optokinetic pattern test (OKP test)

5)mobilization of spontaneous nystagmus through optokinetic stimulation.

The first four above procedures have their respective importance and should be performed as a matter of routine in all vertigo or loss-of-balance cases. the third, fourth and fifth tests are performed by using electronystagmography, the clinical significance of which cannot be overemphasized in optokinetic Dattern test, as i t is termed in our clinic, is helpful both for differentiation of spontaneous nystagmus and quantitative assessment of the intensity of spontaneous vestibular nystagmus.The final procedure, in which optokinetic after-nystagmus is compared between that of left and right, is performed especially in cases where spontaneous nystagmus is suspected but not definitely demonstrated in the preceding four procedures.