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NYSTAGMUS |
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horizontal nystagmus: |
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labyrinthine and vestibular causes: (damage to inner ear, VIIIth nerve, VIIIth nerve nucleus or its brainstem connections )(NB: labyrinthine causes usually also give vertigo, vomiting, deafness � tinnitus) |
acute labyrinthitis acute alcoholism middle ear disease or surgery Meniere's disease multiple sclerosis syringobulbia basilar artery ischaemia |
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cerebellar causes (lesions of lateral lobes): |
multiple sclerosis hereditary ataxias vascular lesions phenytoin barbiturates alcohol |
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ataxic nystagmus [ie. nystagmus greater in abducting eye, with impaired adduction; damage to medial longitudinal fasciculus causing internuclear ophthalmoplegia]: |
multiple sclerosis (usually bilateral)brainstem vascular disease (unilateral) |
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vertical nystagmus: |
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sedatives, especially phenytoin brainstem disease (usually causes horizontal nystagmus)foramen magnum lesions (down-beating nystagmus)pinealoma (inability to look up and adductor nystagmus) |
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pendular and rotary nystagmus: |
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congenital [decreased by convergence; appears to convert to jerk nystagmus on lateral gaze] |
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inability to fix (partial blindness): |
albinism severe refractive errors macular disease |
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positional nystagmus: |
peripheral type [+ marked vertigo = benign paroxysmal positional vertigo]central type (vertigo not marked):lesions of cerebellum / brainstem / vestibular connections, eg. ms, tumours, alcohol, encephalitis, vascular, syringobulbia |
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