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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Vertical nystagmus may occur in caloric testing when only horizontal is expected. We examined this occurrence in 112 normal subjects and in 339 patients with dizziness. Vertical nystagmus was found in 29 percent of normals and in 12 percent of patients with dizziness, more often with hot than cool caloric stimuli and it is always accompanied by horizontal nystagmus. The finding occurred with peripheral and central nervous system diagnoses as well as with patients whose dizziness was considered psychogenic or was undiagnosed. Maximum slow component velocity (SCV) of vertical nystagmus was usually half or less than that of the nystagmus in the horizontal lead. The SCV time profiles of the nystagmus in horizontal and vertical leads differed considerably. Possible origins of vertical nystagmus are discussed. Whatever the origin, it is clear that the finding of vertical nystagmus in routine caloric testing does not automatically denote disease of the central nervous system.
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PMID:Vertical nystagmus in routine caloric testing. 303 61

Vestibular syndromes are one of the commonest paroxysmal disorders in our clinical practice. These consist of vertigo, oculomotor abnormalities (nystagmus), postural changes and nausea/vomiting. Vertigo can be classified as real vertigo and dizziness, based upon the presence of clinical rotatory perception. In order to diagnose a responsible lesion for various central and peripheral vestibular syndromes, we have to carefully observe nystagmus in patients with acute vertigo. Gaze-evoked nystagmus is the most important nystagmus in patients with the central vestibular syndromes. The finding is easily found at the bed side examination. In order to keep a velocity-position neural signal such as gaze holding, the neural structure to hold and maintain the neural command for a saccade is hypothesized and this has been called as the brainstem neural integrator, which sends tonic-step commands for eccentric gaze. If this fails then the integrator becomes leaky and the eyes drift back to the central position. This movement necessitates corrective saccades, hence gaze-evoked nystagmus will ensue. Vertical nystagmus such as primary position upbeat or downbeat nystagmus is also seen only in the central vestibular syndromes. The detection and diagnosis of these characteristic nystagmus are essential for primary clinicians who care patients with acute vertigo.
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PMID:[Overview: diagnosis of vestibular syndromes]. 2227 89