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Mechanisms of nystagmus.

The slow phases of nystagmus can be divided into four types based on their wave forms: linear, exponentially decaying, exponentially increasing, and sinusoidal. The former three give risk to "jerk" nystagmus; the last to "pendular" nystagmus. The drift of the eyes that creates the slow phase of nystagmus can be analyzed by considering the mechanisms that normally hold the eyes still so that images are stable upon the retina for best visual acuity. Thus, we have a vestibular-optokinetic system to keep images of stationary objects stable on the retina during head rotation; a pursuit system to keep images of moving objects stable on the fovea during smooth trackings; and a gaze-holding network (neural integrator) to provide the appropriate tonic innervation to the ocular motor neurons to hold positions of gaze. It is disorders of these systems that create nystagmus.

Biomechanical Phenomena↗

[Comparative studies of the results of caloric vestibular tests and classical torsion swing tests].

Vestibular Paresis (PL) and Directional Preponderance (PD) are the measurements found on caloric testing described by Fitzgerald and Hallpike (1942); frequency nystagmogram is the typical result of the torsion swing test of the French school. The differences between the two methods stimulated us to make a comparison of the results. Seventy-eight patients affected by unilateral peripheral vestibulopathy in various degree of compensation were submitted to both tests. Frequency nystagmogram was transformed, for calculation purposes, into normalized percentual difference (SSP). SSP and PD were found highly significantly correlated and were considered as equivalent from the statistical point of view. SSP and PL were completely independent at slow velocity stimulation. Using high velocities of stimulation a correlation was demonstrated between SSP and PL; unfortunately to the elevation of SSP corresponds a so minimal increasing of PL that the correlation is scarcely useful from the clinical point of view.

Caloric Tests↗