d. Bedside examination »
FINDINGS OF CLINICAL EXAMINATION

-  -  Oculomotor signs
-  -  -  Third, fourth and sixth cranial nerve palsies
4 2 4 2 3 2 3 3
-  -  -  Skew deviation and ocular tilt reaction
3 3 3 2 4 4 4 4
-  -  -  Internuclear ophthalmoplegia
3 2 3 3 4 2 4 4
-  -  -  One and a half syndrome
3 2 3 1 4 2 4 1
-  -  -  Convergence insufficiency
3 2 3 2 3 2 3 3
-  -  -  Decompensation of phorias
3 2 3 2 2 1 2 2
-  -  -  Spasm of the near triad
3 2 2 1 2 1 2 1
-  -  -  Limitations of ductions (including thyroid eye disease, congenital fibrosis of extra-ocular muscles)
3 2 2 1 3 2 3 1
-  -  -  Congenital miswiring syndromes (Duane’s syndrome, Moebius syndrome)
3 2 2 NA 3 2 3 NA
-  -  -  Supranuclear palsies
3 2 2 1 4 2 4 1
-  -  -  Ocular motor apraxia
3 2 2 1 3 2 3 1
-  -  -  Monocular elevation paralysis
3 2 2 1 3 2 3 1
-  -  Nystagmus and disorders of ocular stability
-  -  -  Nystagmus trajectory: reference frames, planes and directions
-  -  -  - 
4 4 4 2 NA NA NA NA

Open Access: Yes


Eggers, S. D., Bisdorff, A., Von Brevern, M., Zee, D. S., Kim, J., Perez-Fernandez, N., Welgampola, M. S., Della Santina, C. C., & Newman-Toker, D. E. (2019). Classification of vestibular signs and examination techniques: Nystagmus and nystagmus-like movements. Journal of Vestibular Research, 29(2–3), 57–87. https://doi.org/10.3233/ves-190658

Link
https://content.iospress.com/articles/journal-of-vestibular-research/ves190658

Description
This article presents a classification and definitions for types of nystagmus and other oscillatory eye movements

Keywords
nystagmus, upbeat, downbeat, torsional, end-point, optokinetic, magnetic, spontaneous, recovery, direction-fixed, periodic alternating, latent, infantile, oculopalatal, oculomasticatory, seesaw, epileptic, pursuit-paretic, gaze-evoked, gaze, gaze holding, degree, rebound, centripetal, positional, headshaking, cross-coupled, sound-induced, valsalva, pressure, vibration, hyperventilation, pursuit, saccadic intrusion, osscilation, square-wave jerks, macrosaccadic, opsoclonus, convergence-retraction, bobbing, myokymia, superior oblique, ping-pong, gaze, pendular, physiologic

Reviewer
Raymond van de Berg

Topics
-  -  -  - 
4 4 4 4 4 4 4 4

Open Access: Yes


Eggers, S. D., Bisdorff, A., Von Brevern, M., Zee, D. S., Kim, J., Perez-Fernandez, N., Welgampola, M. S., Della Santina, C. C., & Newman-Toker, D. E. (2019). Classification of vestibular signs and examination techniques: Nystagmus and nystagmus-like movements. Journal of Vestibular Research, 29(2–3), 57–87. https://doi.org/10.3233/ves-190658

Link
https://content.iospress.com/articles/journal-of-vestibular-research/ves190658

Description
This article presents a classification and definitions for types of nystagmus and other oscillatory eye movements

Keywords
nystagmus, upbeat, downbeat, torsional, end-point, optokinetic, magnetic, spontaneous, recovery, direction-fixed, periodic alternating, latent, infantile, oculopalatal, oculomasticatory, seesaw, epileptic, pursuit-paretic, gaze-evoked, gaze, gaze holding, degree, rebound, centripetal, positional, headshaking, cross-coupled, sound-induced, valsalva, pressure, vibration, hyperventilation, pursuit, saccadic intrusion, osscilation, square-wave jerks, macrosaccadic, opsoclonus, convergence-retraction, bobbing, myokymia, superior oblique, ping-pong, gaze, pendular, physiologic

Reviewer
Raymond van de Berg

Topics
-  -  -  - 
4 4 4 2 4 4 4 2

Open Access: Yes


Eggers, S. D., Bisdorff, A., Von Brevern, M., Zee, D. S., Kim, J., Perez-Fernandez, N., Welgampola, M. S., Della Santina, C. C., & Newman-Toker, D. E. (2019). Classification of vestibular signs and examination techniques: Nystagmus and nystagmus-like movements. Journal of Vestibular Research, 29(2–3), 57–87. https://doi.org/10.3233/ves-190658

Link
https://content.iospress.com/articles/journal-of-vestibular-research/ves190658

Description
This article presents a classification and definitions for types of nystagmus and other oscillatory eye movements

Keywords
nystagmus, upbeat, downbeat, torsional, end-point, optokinetic, magnetic, spontaneous, recovery, direction-fixed, periodic alternating, latent, infantile, oculopalatal, oculomasticatory, seesaw, epileptic, pursuit-paretic, gaze-evoked, gaze, gaze holding, degree, rebound, centripetal, positional, headshaking, cross-coupled, sound-induced, valsalva, pressure, vibration, hyperventilation, pursuit, saccadic intrusion, osscilation, square-wave jerks, macrosaccadic, opsoclonus, convergence-retraction, bobbing, myokymia, superior oblique, ping-pong, gaze, pendular, physiologic

Reviewer
Raymond van de Berg

Topics
-  -  -  - 
4 4 4 3 4 4 4 3

Open Access: Yes


Eggers, S. D., Bisdorff, A., Von Brevern, M., Zee, D. S., Kim, J., Perez-Fernandez, N., Welgampola, M. S., Della Santina, C. C., & Newman-Toker, D. E. (2019). Classification of vestibular signs and examination techniques: Nystagmus and nystagmus-like movements. Journal of Vestibular Research, 29(2–3), 57–87. https://doi.org/10.3233/ves-190658

Link
https://content.iospress.com/articles/journal-of-vestibular-research/ves190658

Description
This article presents a classification and definitions for types of nystagmus and other oscillatory eye movements

Keywords
nystagmus, upbeat, downbeat, torsional, end-point, optokinetic, magnetic, spontaneous, recovery, direction-fixed, periodic alternating, latent, infantile, oculopalatal, oculomasticatory, seesaw, epileptic, pursuit-paretic, gaze-evoked, gaze, gaze holding, degree, rebound, centripetal, positional, headshaking, cross-coupled, sound-induced, valsalva, pressure, vibration, hyperventilation, pursuit, saccadic intrusion, osscilation, square-wave jerks, macrosaccadic, opsoclonus, convergence-retraction, bobbing, myokymia, superior oblique, ping-pong, gaze, pendular, physiologic

Reviewer
Raymond van de Berg

Topics
-  -  -  Attributes of nystagmus
-  -  -  - 
4 4 4 3 4 4 4 4

Open Access: Yes


Eggers, S. D., Bisdorff, A., Von Brevern, M., Zee, D. S., Kim, J., Perez-Fernandez, N., Welgampola, M. S., Della Santina, C. C., & Newman-Toker, D. E. (2019). Classification of vestibular signs and examination techniques: Nystagmus and nystagmus-like movements. Journal of Vestibular Research, 29(2–3), 57–87. https://doi.org/10.3233/ves-190658

Link
https://content.iospress.com/articles/journal-of-vestibular-research/ves190658

Description
This article presents a classification and definitions for types of nystagmus and other oscillatory eye movements

Keywords
nystagmus, upbeat, downbeat, torsional, end-point, optokinetic, magnetic, spontaneous, recovery, direction-fixed, periodic alternating, latent, infantile, oculopalatal, oculomasticatory, seesaw, epileptic, pursuit-paretic, gaze-evoked, gaze, gaze holding, degree, rebound, centripetal, positional, headshaking, cross-coupled, sound-induced, valsalva, pressure, vibration, hyperventilation, pursuit, saccadic intrusion, osscilation, square-wave jerks, macrosaccadic, opsoclonus, convergence-retraction, bobbing, myokymia, superior oblique, ping-pong, gaze, pendular, physiologic

Reviewer
Raymond van de Berg

Topics
-  -  -  -  Binocularity
4 4 4 1 4 4 4 1
-  -  -  -  Conjugacy (conjugate, disconjugate)
4 4 4 1 4 4 4 1
-  -  -  -  Velocity
4 4 4 2 4 4 4 2
-  -  -  -  Waveform (jerk, pendular)
4 4 4 2 4 4 4 3
-  -  -  -  Frequency
4 4 4 2 4 4 4 2
-  -  -  -  Amplitude
4 4 4 2 4 4 4 2
-  -  -  -  Intensity
4 4 4 2 4 4 4 2
-  -  -  -  Temporal profile (continuous, intermittent)
4 4 4 3 4 4 4 3
-  -  -  -  Age of first appearance (congenital, infantile)
3 3 4 2 NA NA NA NA
-  -  -  PHYSIOLOGIC NYSTAGMUS
-  -  -  -  Physiologic end-point nystagmus
4 4 4 4 4 4 4 4
-  -  -  -  Per-rotational nystagmus
4 4 4 3 4 4 4 3
-  -  -  -  Post-rotational nystagmus
4 4 4 3 4 4 4 3
-  -  -  -  Optokinetic nystagmus
4 4 4 3 4 4 4 3
-  -  -  -  Optokinetic after-nystagmus
3 3 3 2 2 2 2 2
-  -  -  -  Caloric nystagmus
4 4 4 4 4 4 4 4
-  -  -  -  Magnetic vestibular stimulation (MVS)-induced nystagmus
2 2 2 1 1 1 1 1
PATHOLOGIC NYSTAGMUS
-  -  -  -  Spontaneous nystagmus
-  -  -  -  -  Spontaneous peripheral vestibular nystagmus
-  -  -  -  -  Spontaneous peripheral vestibular nystagmus, inhibitory type
4 4 4 4 4 4 4 4
-  -  -  -  -  Spontaneous peripheral vestibular nystagmus, excitatory type
4 4 4 4 4 4 4 4
-  -  -  -  -  Recovery nystagmus
4 4 4 3 4 4 4 3
-  -  -  -  -  Spontaneous central vestibular nystagmus
-  -  -  -  Gaze-evoked nystagmus
-  -  -  -  -  Predominantly horizontal central vestibular nystagmus
-  -  -  -  -  Gaze-holding nystagmus (unilateral, bilateral, vertical)
3 3 3 3 4 4 4 3
-  -  -  -  -  Direction-fixed horizontal central vestibular nystagmus
4 3 4 3 3 3 3 3
-  -  -  -  -  First degree vestibular nystagmus
3 3 3 3 4 4 4 3
-  -  -  -  -  Periodic alternating nystagmus
4 3 4 3 3 3 3 3
-  -  -  -  -  Vestibular plus gaze-holding nystagmus
3 3 3 2 4 4 4 2
-  -  -  -  -  Latent nystagmus
4 3 4 2 4 3 4 2
-  -  -  -  -  Rebound nystagmus
3 3 3 3 3 3 3 3
-  -  -  -  -  Centripetal nystagmus
3 3 3 3 3 3 3 3
-  -  -  -  Triggered nystagmus
-  -  -  -  -  Predominantly vertical or torsional central vestibular nystagmus
-  -  -  -  -  Downbeat nystagmus
4 3 4 3 4 4 4 3
-  -  -  -  -  Upbeat nystagmus
4 3 4 3 4 4 4 3
-  -  -  -  -  Torsional nystagmus
4 3 4 3 4 4 4 3
-  -  -  -  -  Other spontaneous central nystagmus forms
-  -  -  -  -  Positional nystagmus
-  -  -  -  -  Infantile nystagmus
3 3 4 2 3 3 3 2
-  -  -  -  -  Benign paroxysmal positional nystagmus (BPPN)
-  -  -  -  -  Posterior semicircular canal BPPN
4 4 4 4 4 4 4 4
Horizontal semicircular canal BPPN
4 4 4 4 3 3 3 4
-  -  -  -  -  Pseudo-spontaneous nystagmus
-  -  -  -  -  Anterior semicircular canal BPPN
3 3 3 3 3 3 3 3
-  -  -  -  -  Other forms of peripheral positional nystagmus
3 3 3 3 3 3 3 3
-  -  -  -  -  Central positional nystagmus
4 3 3 3 4 3 4 3
-  -  -  -  -  Headshaking-induced nystagmus
3 3 3 4 4 4 4 4
-  -  -  -  -  Acquired pendular nystagmus
-  -  -  -  -  Oculopalatal tremor
3 3 3 2 3 3 3 2
-  -  -  -  -  Oculomasticatory myorhythmia
3 3 3 1 3 3 3 1
-  -  -  -  -  Cross-coupled nystagmus
3 3 3 3 4 4 4 3
-  -  -  -  -  Seesaw nystagmus
3 3 3 2 3 3 3 2
-  -  -  -  -  Sound-induced nystagmus
3 4 4 3 3 4 4 3
-  -  -  -  -  Epileptic nystagmus
3 3 3 1 3 2 2 1
-  -  -  -  -  Valsalva-induced nystagmus
3 4 4 3 3 4 4 3
-  -  -  -  -  Pursuit-paretic nystagmus
3 3 3 1 3 2 2 1
-  -  -  -  -  Pressure-induced nystagmus
3 4 4 3 3 4 4 3
-  -  -  -  -  Vibration-induced nystagmus
3 3 3 4 4 4 4 4
-  -  -  -  -  Hyperventilation-induced nystagmus
3 3 3 3 4 4 4 3
-  -  -  -  -  Pursuit-induced nystagmus
3 2 3 2 3 3 3 2
-  -  -  NYSTAGMUS-LIKE MOVEMENTS
-  -  -  -  Saccadic intrusions and oscillations
-  -  -  -  -  Square-wave jerks
3 3 3 3 4 4 4 3
-  -  -  -  -  Macrosaccadic oscillations
3 2 3 2 4 4 4 2
-  -  -  -  -  Saccadic pulses
3 2 3 2 3 2 2 2
-  -  -  -  -  Ocular flutter
4 3 4 2 3 3 3 2
-  -  -  -  -  Opsoclonus
4 3 4 2 4 4 4 2
-  -  -  -  -  Voluntary saccadic oscillations
3 3 3 2 3 3 3 2
-  -  -  -  Other nystagmus-like movements
-  -  -  -  -  Convergence-retraction nystagmus
3 2 3 1 3 2 2 1
-  -  -  -  -  Ocular oscillations in spasmus nutans
3 2 3 1 2 2 2 1
-  -  -  -  -  Ocular bobbing and its variants
3 2 3 1 3 2 2 1
-  -  -  -  -  Superior oblique myokymia
3 2 3 1 2 2 2 1
-  -  -  -  -  Ping-pong gaze
2 1 2 1 2 1 1 1
-  -  -  -  -  Pendular pseudonystagmus
3 2 3 1 3 1 1 1
-  -  Identify gait and movement patterns
-  -  -  Cautious
4 4 4 4 4 4 4 4
-  -  -  Cerebellar ataxia
4 3 3 4 4 2 3 4
-  -  -  Spastic ataxic
4 2 3 4 4 1 3 4
-  -  -  Extrapyramidal pattern
4 2 3 4 4 1 3 4
-  -  -  Neuro-muscular pattern
4 2 3 4 4 1 3 4
-  -  -  Apraxic pattern
4 2 3 4 4 1 3 4
-  -  -  Stepping
4 2 3 4 4 1 3 4
-  -  -  Pusher syndrome
4 2 3 4 4 2 3 4
-  -  -  Sensory / proprioceptive loss
4 2 3 4 4 2 3 4
-  -  -  Functional
4 3 3 4 4 2 3 4
-  -  Pediatric aspects of clinical examination findings
-  -  -  Motor developmental delay
2 2 4 4 2 2 2 4

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