Recovery Phase Spontaneous Nystagmus, Its Existence and Clinical Implication

Abstract

Background and ObjectivesDetermination of the lesion side based on the direction of the nystagmus could result in confusions to the clinicians due to mismatch between the vestibular function tests and also between vestibular and audiologic features. To minimize these mistakes, we elucidated the clinical manifestation and vestibular function test results in cases with recovery spontaneous nystagmus (rSN).Subjects and MethodsPatients who visited ENT clinic of tertiary referral hospital for acute onset continuous vertigo from January 2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo, time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each time point of SN, vestibular function tests and hearing function tests were performed.ResultsWe confirmed the rSN among patients with unilateral vestibulopathy and demonstrated that high gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SN direction and contralateral caloric weakness could indicate the recovery state of patients and nystagmus observed in this stage is recovery phase nystagmus.ConclusionsIn acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.

Recovery Nystagmus in Vestibular Neuritis with Minimal Canal Paresis. Clinical Observation and Interpretation

“…They report the observation of recovery nystagmus in these patients in a statistically higher grade than the group of patients with CP > 25% (the lower limits of their lab). Lee et al [ 5 ] reported no change of symptoms at the time of recovery nystagmus in their patients’ group, as has happened with our patient.…”

“…(B) There is a wide variability regarding the time of its appearance and the duration of its presence. Lee et al [ 5 ] found a range of recovery nystagmus detection time at 17.56 ± 14.16 days after the onset of AVD. Lange [ 6 ] reports registration of recovery nystagmus from as early as 5 days to very late after injury (2 years).…”