Can nystagmus that changes direction with gaze ever be benign?
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- Опубліковано 4 жов 2024
- End gaze nystagmus is a benign cause of nystagmus that changes direction with gaze. It's compared to bidirectional (direction changing) gaze evoked nystagmus which is always concerning for a central cause.
Thank you! ER doc here, and I've noticed this on multiple patients lately when trying to assess for nystagmus. The finding confused me bc the nystagmus was "bidirectional" but the rest of the exam and history did not fit at all with a central cause of dizziness. I found a few papers describing this but always try to not to fall into the "I found one paper that supported my gut feeling" trap. Your explanation gives me much more confidence differentiating this benign finding from a red flag for a posterior stroke or other emergency. Very helpful!
You somehow made a video of my exact question in mind. Thank you a much.
Thanks Peter, that was very informative and interesting. BTW I review your older videos regularly. Cheers
Thanks Dr. John’s. Always great info.
Great video. I’ve been caught with thinking a patient had a central cause due to bidirectional nystagmus. It was just end gaze nystagmus. I wish I had learned this earlier.
This is amazing ! Dr. John’s is my vertigo Sensei !
Hey bud, thanks again for your tips in the past.
Just wanted to say Ive delt with the bppv several times in the last 6 months, each time the eply has been the fix due to tha particular canal.
Yesterday I woke up with it again, so I did the dix halpike and it didnt seem to stir it up much, so I tried eply anyways, didnt react as usual, so then with more testing myself and filming the nystagmus, I realized it was in the horizontal canal.
After a few Log Roll maneuvers I was much better, today Im just having the residual feeling, not fun either but better than before................maybe Ill do it again after work incase some still lingers.
I want to tell your viewers to always try and seek a professional like you, especially if they have already done maneuvers and nothing is working.
Unless your very familiar and somewhat educated on BPPV, make sure to see someone like this gentleman, before you give up hope.
There is alot more to it than ppl think.
This guy knows his stuff.
I hope with further research we can eventually find a way to prevent it fully but not yet.
Thanks for doing what you do man, and actu caring about the patients, seems you do.
Take care.
Awesome as always!
This was excellent. Thank you!
Great information. Thank you
Thank you for clarifying this , I recently very confidently tried to admit a patient with bi directional nystagmus to a Neurologist as central cause and was asked about this very same thing.
Interesting! So they had end gaze nystagmus?
Awesome as always! Love it!
What was the complaint of second patient
As I recall, non-specific dizziness.
ماهو علاج الرأرأه المزمنه ؟
Is that picture behind you from the Bayoux tapestry?
"Where Harold, Duke of the English and his soldiers, ride to Bosham". headlesschicken.ca/eng204/texts/BayeuxTapestry/
Was #2 intoxicated?
Not at all.