Gaze‐evoked nystagmus induced by alcohol intoxication

Romano, Fausto; Tarnutzer, Alexander A.; Straumann, Dominik; Ramat, Stefano; Bertolini, Gérard

doi:10.1113/jp273204

Cited by 24 publications

(16 citation statements)

References 56 publications

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“…These limitations should be considered when comparing oculomotor findings in neuro-otology patients to normal subjects, as these study results may overestimate the 'normal' range of nystagmus eye movement. Furthermore, substances such as alcohol and nicotine may increase nystagmus, while some medications such as benzodiazepines are known to reduce nystagmus, and were not controlled for [10,18,25,27].…”

Section: Discussionmentioning

confidence: 99%

Nystagmus characteristics of healthy controls

Young

Rosengren

D’Souza

et al. 2020

VES

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BACKGROUND: Healthy controls exhibit spontaneous and positional nystagmus which needs to be distinguished from pathological nystagmus. OBJECTIVE: Define nystagmus characteristics of healthy controls using portable video-oculography. METHODS: One-hundred and one asymptomatic community-dwelling adults were prospectively recruited. Participants answered questions regarding their audio-vestibular and headache history and were sub-categorized into migraine/non-migraine groups. Portable video-oculography was conducted in the upright, supine, left- and right-lateral positions, using miniature take-home video glasses. RESULTS: Upright position spontaneous nystagmus was found in 30.7% of subjects (slow-phase velocity (SPV), mean 1.1±2.2 degrees per second (°/s) (range 0.0 – 9.3). Upright position spontaneous nystagmus was horizontal, up-beating or down-beating in 16.7, 7.9 and 5.9% of subjects. Nystagmus in at least one lying position was found in 70.3% of subjects with 56.4% showing nystagmus while supine, and 63.4% in at least one lateral position. While supine, 20.8% of subjects showed up-beating nystagmus, 8.9% showed down-beating, and 26.7% had horizontal nystagmus. In the lateral positions combined, 37.1% displayed horizontal nystagmus on at least one side, while 6.4% showed up-beating, 6.4% showed down-beating. Mean nystagmus SPVs in the supine, right and left lateral positions were 2.2±2.8, 2.7±3.4, and 2.1±3.2°/s. No significant difference was found between migraine and non-migraine groups for nystagmus SPVs, prevalence, vertical vs horizontal fast-phase, or low- vs high-velocity nystagmus (<5 vs > 5°/s). CONCLUSIONS: Healthy controls without a history of spontaneous vertigo show low velocity spontaneous and positional nystagmus, highlighting the importance of interictal nystagmus measures when assessing the acutely symptomatic patient.

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Section: Discussionmentioning

confidence: 99%

Nystagmus characteristics of healthy controls

Young

Rosengren

D’Souza

et al. 2020

VES

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“…This time window was defined for each participant once, and remained the same for all parts of all trials of the same participant. For each trial, the data from both eyes (viewing and non-viewing eye) were pooled as validated by previous works (6,20). In addition, the median eye velocity at the beginning and the end of eccentric gaze fixation period (step B) was extracted using the same time window as described above (i.e., with a time window of, e.g., 3 s the median of the first 3 s and the one of the last 3 s of the eye drift velocity during step B was calculated).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Characteristics of Physiological Gaze-Evoked and Rebound Nystagmus: Implications for Testing Their Pathological Counterparts

et al. 2020

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Objective: Cerebellar diseases frequently affect the ocular motor neural velocity-to-position integrator by increasing its leakiness and thereby causing gaze-evoked nystagmus (GEN) and rebound nystagmus (RN). Minor leakiness is physiological and occasionally causes GEN in healthy humans. We aimed to evaluate the characteristics of GEN/RN in healthy subjects for better differentiation between physiological and pathological GEN/RN. Methods: Using video-oculography, eye position was measured in 14 healthy humans at straight ahead eye position before and after, and during 30 s of ocular fixation at 4 horizontal eccentric targets between 30 • and 45 •. We determined the eye drift velocity and the prevalence of nystagmus before/during/after eccentric fixation. Results: Eye drift velocities during (range: 0.62 ± 0.53 • /s to 1.78 ± 0.69 • /s) and after eccentric gaze (range: 0.28 ± 0.52 • /s to 1.48 ± 1.02 • /s) increased with the amount of gaze eccentricity (30 •-45 •). During continuous eccentric gaze, eye drift velocities decreased by 0.41 ± 0.18 • /s at 30 • , and 0.84 ± 0.38 • /s at 45 • gaze eccentricity. GEN was elicited in 71% of subjects at 30 • gaze eccentricity. Twenty-one percent showed RN thereafter. This prevalence increased to 100% (GEN)/72% (RN) at 45 • gaze eccentricity. RN found after 30 • gaze eccentricity was of low velocity (0.82 ± 0.21 • /s) and occurred after minor drift velocity decrease during prior eccentric gaze (0.43 ± 0.15 • /s). Conclusion: GEN and RN should be tested using horizontal gaze eccentricities of <30 • , since most healthy subjects physiologically show GEN and RN at higher eccentricities. In case of an uncertain result, both the reduction of eye drift velocity during eccentric gaze and the velocity of RN can be analyzed to distinguish physiological from pathological nystagmus.

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“…15 Other causes of transient gaze-evoked nystagmus are alcohol consumption, migraine, intoxication (lead, aluminum, etc), pharmacological inactivation of ocular motor integrator in patients using sedatives, barbiturates, anticonvulsants, or marijuana which usually involve neurofunctional changes in Purkinje cells at the level of anterior and superior vermis and paravermal parts of anterior lobe in more advanced cases. [16][17][18] Patients with head trauma, cerebellar tumors, cranial surgery, and viral infections may also exhibit gaze-evoked nystagmus. 19,20 Five patients had migraine, 2 patients had a story of trauma, and 1 patient was using antidepressant drug in our series.…”

Section: Discussionmentioning

confidence: 99%

Optokinetic Analysis in Patients With Spontaneous Horizontal Gaze-Evoked Nystagmus Without Radiological Neuropathology

2019

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Gaze-evoked nystagmus is not rare among those who have acute balance problem and may indicate a cerebellar dysfunction that is associated with a broad spectrum of disorders. The aim of this study is to analyze optokinetic response in those patients. Eleven males and 7 females (age range: 25-60, 42.5 [9.75]) with gaze-evoked nystagmus were analyzed with optokinetic test (Micromed Inc). Nystagmus was elicited by a stimulator light spot moving across the patient’s visual field at a target speed of 30 degree/second. Ten age-matched healthy participants served as controls. The gain and slow-phase velocity difference in oculomotor response from left and right stimulus was compared in patients and the control participants. One-way analysis of variance test was used for multiple variance analysis of the groups. Statistical significance was set at P < .05. Slow-phase velocity of gaze-evoked nystagmus was ranging between 6 and 19 degree/second. The mean slow-phase velocity of gaze-evoked nystagmus to the right and left was 8.1 (3.81) and 6.8 (4.67) degree/second, respectively. Optokinetic gain was out of normal limits in 10 (55.5%) patients. Comparison of mean gain difference between the patients and the normal participants was statistically significant ( P = .025). No statistical difference was found in mean slow-phase velocity difference in optokinetic nystagmus between control participants and patients ( P > .05 [.099]). An acute-onset balance problem may be associated with dysfunction of separate populations of neurons in the brainstem and cerebellum even if there is no radiological neuropathy since gaze-evoked nystagmus is a sign of neural integrator dysfunction. Patients with gaze-evoked nystagmus and optokinetic abnormalities may have disruption of cerebellar pathways and should be followed closely.

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Gaze‐evoked nystagmus induced by alcohol intoxication

Cited by 24 publications

References 56 publications

Nystagmus characteristics of healthy controls

Nystagmus characteristics of healthy controls

Prevalence and Characteristics of Physiological Gaze-Evoked and Rebound Nystagmus: Implications for Testing Their Pathological Counterparts

Optokinetic Analysis in Patients With Spontaneous Horizontal Gaze-Evoked Nystagmus Without Radiological Neuropathology

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