What is the focus of history in the evaluation of acquired nystagmus?

Updated: Oct 17, 2018
  • Author: Christopher M Bardorf, MD, MS; Chief Editor: Edsel Ing, MD, MPH, FRCSC  more...
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Answer

A thorough history is important to help determine the etiology of the nystagmus. Important aspects of the history include the following:

  • Age of onset of the nystagmus, whether it is constant or intermittent, the presence of any aggravating or alleviating factors (eg, head position)

  • Presence or absence of vertigo, oscillopsia (an illusory motion of the seen world), [10] and sensation of disequilibration suggest a lesion of the vestibular system.

  • Deafness or tinnitus is present with peripheral lesions of the vestibular system.

  • Presence of diplopia, particularly in certain positions of gaze: Patients with INO may report diplopia only on lateral gaze or intermittent blurring of vision.

  • Ask questions regarding the presence of any associated symptoms, such as symptoms related to demyelinating disease (eg, a history of loss of vision, eye pain, or numbness or weakness of the extremities), symptoms related to cerebrovascular accident (eg, hemiplegia), and predispositions to thiamine deficiency (eg, alcoholism, bariatric surgery)

  • Medications such as anticonvulsants and lithium may be associated with nystagmus


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