Gaze-Evoked Nystagmus

Abstract

Gaze-evoked nystagmus is the one of the most common types of nystagmus encountered in clinical practice, but it is poorly localizing. It is often confused with physiologic “end-point” nystagmus. In this chapter, we begin by discussing the pathogenesis of gaze-evoked nystagmus. We next describe its clinical features as well as features that help distinguish it from “end-point” nystagmus, which is physiologic and of no concern. We then review common causes of gaze-evoked nystagmus, which include drugs (especially anticonvulsants), cerebellar degenerations, multiple sclerosis, and episodic ataxias. Lastly, we discuss the diagnostic approach to the patient with gaze-evoked nystagmus and basic management strategies.

A Portrait of Menière's Disease Using Contemporary Hearing and Balance Tests

“…Three patients (6.4%) had additional torsional components to their positional vertical nystagmus. Four patients (1.1%) had gaze-evoked nystagmus, this was thought to represent normal endpoint nystagmus (23). Magnetic resonance imaging (MRI) was performed in 220 patients to exclude vestibular schwannoma.…”