Describing Nystagmus

When describing a nystagmus, record as much information about the movement as possible. The nystagmus should be described by the type of movement, the frequency (the number of oscillations per unit of time), the amplitude (the distance traveled during the movement), and the direction, which may be horizontal, vertical, rotary, oblique, or circular (Fig. 2-7). A complete description often aids in the diagnosis and the follow-up of the patient's subsequent course.4 Observing the nystagmus for an extended period of time is helpful in trying to determine its characteristics; this is particularly important in identifying periodic alternating nystagmus, a jerk nystagmus that changes directions every 60 to 90s. Allowing the child to walk and move

TABLE 2-5. Localizing Types of Nystagmus.

Nystagmus

Location/etiology

Latent

Congenital

Manifest latent

Congenital

Spasmus nutans

Chiasm/suprachiasmal

Periodic alternating

Brainstem/cerebellum

See-saw

Midbrain/suprachiasmal

Retraction

Dorsal midbrain

Downbeat

Cerebellum/cervicomedullary junction

Opsoclonus

Neuroblastoma

Left jerk

Left jerk

Pendular

Pendular

Right jerk

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