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Pulse-synchronous torsional nystagmus
Ivan Milenkovic1, Thomas Sycha1, Evelyn Berger-Sieczkowski1
1Department of Neurology, Medical University of Vienna, Wien, Austria.
Practical Neurology
|July 17, 2021
Summary
Spontaneous torsional nystagmus, usually central, can be peripheral. This case shows pulse-synchronous nystagmus indicating a peripheral cause, diagnosed as superior canal dehiscence syndrome.
Area of Science:
- Neurology
- Ophthalmology
- Vestibular Science
Background:
- Torsional nystagmus is typically a sign of central nervous system vestibular disorders.
- Distinguishing central from peripheral causes is crucial for diagnosis and treatment.
Purpose of the Study:
- To report a case of peripheral torsional nystagmus with a unique characteristic.
- To highlight a potential bedside diagnostic sign for differentiating central from peripheral vestibular nystagmus.
Main Methods:
- Clinical case presentation.
- Bedside examination using Frenzel's glasses and pulse oximetry.
- Diagnostic imaging (details not specified in abstract).
Main Results:
- A patient presented with spontaneous, pulse-synchronous torsional nystagmus.
- The nystagmus's clockwise component correlated with the pulse upswing, suggesting a peripheral vestibular origin.
- Left-sided superior canal dehiscence syndrome was diagnosed.
Conclusions:
- Pulse synchronicity in spontaneous torsional nystagmus may indicate a peripheral vestibular cause.
- This finding can aid in distinguishing central from peripheral vestibular torsional nystagmus at the bedside.
- Superior canal dehiscence syndrome is a potential diagnosis for such presentations.
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