Impaired fixation suppression of horizontal vestibular nystagmus during smooth pursuit: pathophysiology and clinical implications.

Korda, Athanasia; Zee, David S; Wyss, Thomas; Zamaro, Ewa; Caversaccio, Marco D; Wagner, Franca; Kalla, Roger; Mantokoudis, Georgios (2021). Impaired fixation suppression of horizontal vestibular nystagmus during smooth pursuit: pathophysiology and clinical implications. European journal of neurology, 28(8), pp. 2614-2621. Wiley 10.1111/ene.14909

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BACKGROUND AND PURPOSE

A peripheral spontaneous nystagmus (SN) is typically enhanced or revealed by removing fixation. Conversely, failure of fixation suppression of SN is usually a sign of a central disorder. Based on Luebke and Robinson (Vision Res 1988, vol. 28 (8), pp. 941-946), who suggested that the normal fixation mechanism is disengaged during pursuit, it is hypothesized that vertical tracking in the light would bring out or enhance a horizontal SN.

METHODS

Eighteen patients with acute vestibular neuritis were studied. Eye movements were recorded using video-oculography at straight-ahead gaze with and without visual fixation, and during smooth pursuit. The slow-phase velocity and the fixation suppression indices of nystagmus (relative to SN in darkness) were compared in each condition.

RESULTS

During vertical tracking, the slow-phase velocity of horizontal SN with eyes near straight-ahead gaze was significantly higher (median 2.7°/s) than under static visual fixation (median 1.2°/s). Likewise, the fixation index was significantly higher (worse suppression) during pursuit (median 48%) than during fixation (median 26%). A release of SN was also suggested during horizontal pursuit, if one assumes superposition of SN on a normal and symmetrical pursuit capability.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Korda, Athanasia; Wyss, Thomas Werner; Zamaro, Ewa; Caversaccio, Marco; Wagner, Franca; Kalla, Roger and Mantokoudis, Georgios

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1468-1331

Publisher:

Wiley

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

06 Jul 2021 12:22

Last Modified:

24 Jul 2021 01:33

Publisher DOI:

10.1111/ene.14909

PubMed ID:

33983645

Uncontrolled Keywords:

fixation suppression nystagmus pursuit vestibular

BORIS DOI:

10.48350/157291

URI:

https://boris.unibe.ch/id/eprint/157291

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