whole story revolves on the idea that vertical nystagmus observed spontaneously in a patient is thought to be due to an intracranial lesion and that one hardly ever thinks of such nystagmus as being due to a peripheral lesion. Dr. Spiegel brings out by experimental means that such nystagmus can be produced by labyrinthine changes. He tries to prove this by puncturing the round windows of a cat. Vertical nystagmus of a type which changes with the position of the cat's head then developed. If the utricle is impaired, the activity of the vertical canals is thereby increased. In other words, lesions in the two labyrinths under certain circumstances will produce vertical nystagmus.He also injects into the middle ears a solution of cocaine and on permitting it to act by diffusion he observes certain reactions take place (although more slowly than after puncturing) in which there is vertical nystagmus, and this time the nystagmus is downward instead of upward.Dr. Spiegel concludes from these experiments that a bilateral peripheral lesion can produce vertical nystagmus.It is not often that one sees vertical nystagmus due to peripheral lesions. Dr. MacKenzie reported a case in which a focal infection produced vertical nystagmus, which disappeared following extraction of a tooth.
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