Neuro-otological findings in psychiatric patients with nystagmus

To evaluate whether neuro-otological tests have clinical significance in psychiatric patients with nystagmus who have inner ear and/or brain dysfunction, we performed neuro-otological tests on 56 psychiatric patients with nystagmus (38 men, 18 women) (age range 40-97; mean age ± SD 61.6 ± 10.5 years). Patients were classified according to the underlying diseases: schizophrenia (25 cases), organic psychiatric disorders (14 cases), alcoholism (16 cases) and excited mental retardation (1 case). Caloric test results showed a normal response in 30 (75%) cases, right canal paresis (CP) in 4 (10%), left CP in 4 (10%) and bilateral CP in 2 (5%). Therefore, 10 (25%) cases had CP. The results of the eye tracking tests (ETT) were sorted into five categories: 4 (8.2%) cases smooth (normal), 8 (16.3%) slightly saccadic, 28 (57.1%) saccadic, 8 (16.3%) ataxic, and 1 (2%) no tracking ability. Therefore, 45 (91.8%) cases had abnormal ETT results. Pure tone audiometry showed normal hearing in 24 (47.1%) cases, right hearing loss (HL) in 3 (5.8%), left HL in 3 (5.8%) and bilateral HL in 21 (41.2%). Therefore, 27 (52.9%) cases had HL. The patients were classified as organic or functional groups. In ETT there was a significant difference between these two groups. These results indicate that neuro-otological tests with video-oculography are very important not only for neurological or neuro-otological patients with nystagmus, but also for psychiatric patients with nystagmus.