Cranial Nerve Disorders Neurology Video Lectures Medical Student VLearning

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http://youtube.com/watch?v=JCjiTUy33Rs

This video demonstrates 3rd degree right beating nystagmus due to an acute left sided vestibular hypofunction, with and without fixation, with the use of infrared video goggles by Vesticam (https://www.vesticam.com) • With fixation, spontaneous nystagmus can be suppressed. In acute cases such as this (this patient's sudden episode of vertigo started 3 days prior to evaluation), you will be able to see spontaneous nystagmus in all three gaze holding positions. Nystagmus will increase when looking into the fast phase of the the nystagmus (in this case, nystagmus increases with right gaze). This is called Alexander's Law. • When fixation is removed, spontaneous nystagmus usually accentuates and increases in amplitude making it significantly more noticeable. This is why having infrared goggles are an extremely valuable tool when evaluating patients who are not acute. In room light, they may appear spontaneous nystagmus free, however, when fixation is removed, spontaneous nystagmus may be present suggesting the possibility of dysfunction. • This video is a good example of direction fixed nystagmus which is indicative of peripheral dysfunction.

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