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Characterization of Optokinetic Nystagmus in Healthy Participants With a Novel Oculography Device.
Otolaryngol Head Neck Surg
January 2025
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.
Objective: To develop a proof-of-concept smart-phone-based eye-tracking algorithm to assess non-pathologic optokinetic (OKN) nystagmus in healthy participants. Current videonystagmography (VNG) is typically restricted to in-office use, and advances in portable vestibular diagnostics would yield immense public health benefits.
Study Design: Prospective cohort study.
Clinical spectrum of positional downbeat nystagmus: a diagnostic approach.
J Neurol
January 2025
Department of Neurology, University of Chicago, 5841 South Maryland Avenue, Chicago, IL, 60637, USA.
Positional downbeat nystagmus (pDBN) is a common finding in dizzy patients, with etiologies ranging from benign paroxysmal positional vertigo (BPPV) to central vestibular lesions. Although peripheral pDBN often presents with distinct clinical features that differentiate it from BPPV, diagnosing its etiology can be challenging. A thorough clinical evaluation, including the physical characteristics of the nystagmus, response to positional maneuvers, and neurological findings, is often sufficient to diagnose conditions that provoke pDBN such as anterior canal BPPV, atypical posterior canal BPPV, and central causes.
View Article and Find Full Text PDFSpontaneous Nystagmus Violating the Alexander's Law: Neural Substrates and Mechanisms.
Cerebellum
January 2025
Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea.
Alexander's law states that spontaneous nystagmus increases when looking in the direction of fast-phase and decreases during gaze in slow-phase direction. Disobedience to Alexander's law is occasionally observed in central nystagmus, but the underlying neural circuit mechanisms are poorly understood. In a retrospective analysis of 2,652 patients with posterior circulations stroke, we found a violation of Alexander's law in one or both directions of lateral gaze in 17 patients with lesions of unilateral lateral medulla affecting the vestibular nucleus.
View Article and Find Full Text PDFWernicke's encephalopathy presenting with confusion and hearing loss.
BMJ Case Rep
January 2025
Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
We present a case of a male in his early 50s assessed in the emergency department with a seemingly clear alcohol history but with classic symptoms of Wernicke's encephalopathy (WE): disorientation, gait ataxia and vertical nystagmus. He also had significant bilateral hearing loss and profound anterograde amnesia. Neuroimaging revealed hallmark signs of WE, including symmetrical T2/fluid-attenuated inversion recovery hyperintensity in the medial thalami.
View Article and Find Full Text PDFDPPX antibody-mediated disease mimicking Wernicke's encephalopathy.
BMJ Case Rep
January 2025
Neurology, Joondalup Health Campus, Joondalup, Western Australia, Australia.
Anti-dipeptidyl-peptidase-like protein 6 antibody-mediated disease is a rare autoimmune encephalitis typically presenting with diarrhoea and/or weight loss, central nervous system hyperexcitability and cognitive dysfunction. We present a case of a young woman with 10 days of diplopia and unsteadiness in the context of dysthymia and significant weight loss over 2 months. Initial examination demonstrated mixed dysconjugate nystagmus and ataxic gait.
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