Term
| Meds for downbeat nystagmus |
|
Definition
Aminopyradines (Baclofen)
Acetazolamide for episodic cases |
|
|
Term
| Mechanism of Aminopyradines |
|
Definition
| potassium channel blockers |
|
|
Term
| 2 ways to move the eyes to dampen downbeat nystagmus |
|
Definition
| Convergence and upgaze will dampen |
|
|
Term
|
Definition
Nystagmus will increase in intensity when gaze is in the direction of the fast beat
Eg. Downbeat will get faster when looking down |
|
|
Term
| 3 most common causes of Downbeat Nystagmus |
|
Definition
Arnold-Chiari Malformations
Cerebellar Degeneration
MS |
|
|
Term
| Where in the brain do we suspect damage when we see downbeat nystagmus |
|
Definition
| Disruption to posterior canal projections to tegmentum of brainstem |
|
|
Term
| If you see downbeat nystagmus is primary gaze, what do you expect to see on lateral gaze |
|
Definition
|
|
Term
| Where in the brain do we suspect damage when we see upbeat nystagmus |
|
Definition
| Damage to anterior canal projections at superior cerebellar peduncle or junction between pons and brainstem (like NPH) |
|
|
Term
| 3 most common causes of Upbeat Nystagmus |
|
Definition
Cerebellar Degeneration
Brainstem/Cerebellar Stroke
MS |
|
|
Term
| Wernicke's encephalopathy is caused by a deficiency of what nutrient |
|
Definition
| Thiamine defiency, which in turn can be caused by alcoholism, malnutrition, anorexia etc. |
|
|
Term
| 3 meds for treatment of upbeat nystagmus |
|
Definition
4-aminopyradine
Clonazepam
Baclofen |
|
|
Term
| In torsional nystagmus how may the location of the lesion correspond to the direction of eye movement |
|
Definition
| Upper pole of the eye to beat AWAY from a central lesion |
|
|
Term
| On what side of the brain would you expect a lesion to be located that is caused extorsional nystagmus on the right eye |
|
Definition
| Right eye is beating to the right, thus we suspect the lesion to be on the left side of the brain |
|
|
Term
| 3 most common causes of torsional nystagmus |
|
Definition
Stroke (40%)
MS
Venous Angioma |
|
|
Term
| Definitive treatment of torsional nystagmus |
|
Definition
| No definitive treatment-just fix the underlying problem |
|
|
Term
| 3 drugs that may dampen torsional nystagmus |
|
Definition
Gabapentin
Baclofen
Clonazepam |
|
|
Term
| Location of lesions causing seesaw nystagmus |
|
Definition
| CHIASM and INC in midbrain |
|
|
Term
| Most common cause of seesaw nystagmus |
|
Definition
|
|
Term
| In terms of seesaw nystagmus, how is a pendular form named compared to the jerk form |
|
Definition
Pendular=seesaw
Jerk=hemi-seesaw |
|
|
Term
| Otolithic imbalance is associated with which type of seesaw nystagmus |
|
Definition
|
|
Term
| Bitemporal hemianopia and other chiasmal disorders are associated with which type f seesaw nystagmus |
|
Definition
|
|
Term
| 4 possible meds for treatment of seesaw nystagmus |
|
Definition
Baclofen
Clonazepam
Gabapentin
Alcohol? |
|
|
Term
| Location of lesion that causes Periodic Alternating Nystagmus |
|
Definition
| Cerebelluar flocculus & nodulus |
|
|
Term
| Causes of Periodic Alternating Nystagmus |
|
Definition
Congenital
Arnold-Chiari
Cerebeller degeneration
MS
Encephalitis/tumours |
|
|
Term
| Treatment of choice for PAN |
|
Definition
|
|
Term
| Any horizontal nystagmus may create what type of astigmatism |
|
Definition
|
|
Term
| What type of PAN does not respond as well to Baclofen? |
|
Definition
| PAN in infantile nystagmus |
|
|
Term
|
Definition
|
|
Term
| Aproximately how often does PAN reverse direction |
|
Definition
|
|
Term
| If PAN is associated with alternating head turns, in which direction would they be? |
|
Definition
| Head turns in direction of quick phase-to move eyes into direction of slow phase |
|
|
Term
| 4 types of eccentric gaze nystagmus |
|
Definition
1. Gaze-Evoked
2. Centripetal & Rebound
3. Dissociated Nystagmus
4. Brun's Nystagmus |
|
|
Term
| Most common form of nystagmus |
|
Definition
|
|
Term
| Causes of Gaze Evoked Nystagmus |
|
Definition
Alcohol
Anticonvulsants
Sedatives
Antidepressants |
|
|
Term
| Gaze-evoked nystagmus is thought to be due to a leaky neural integrator, in which 3 areas? |
|
Definition
Medial Vestibular Nuclei
Nucleus Prepositus Hypoglossi (horizontal)
Interstitial Nucleus of Cajal (vertical) |
|
|
Term
| Term for an eccentric gaze nystagmus that occurs with the fast phase towards primary position instead of away |
|
Definition
|
|
Term
| 2 locations in the brain responsible for Acquired Pendular Nystagmus |
|
Definition
|
|
Term
|
Definition
1. Vision loss
2. Demyelination
3. Oculopalatal Tremor |
|
|
Term
| Which form of nystagmus can be monocular |
|
Definition
| Acquired Pendular Nystagmus |
|
|
Term
| 3 causes discussed forAPN due to vision loss |
|
Definition
Leber's Congenital Amaurosis
Rod-Cone Dystrophy
Severe Amblyopia |
|
|
Term
| 3 causes discussed for APN due to demyelination |
|
Definition
Multiple Sclerosis
Genetic disorders-Pelizaus Merzbacher
Toxic Optic Neuropathy (toluene) |
|
|
Term
|
Definition
|
|
Term
| Location of stroke that causes APN due to oculopalatal tremor |
|
Definition
|
|
Term
| Treatment of choice for APN due to oculopalatal tremor |
|
Definition
|
|
Term
| A significant side effect of Gabapentin (treatment for APN with oculopalatal tremor) |
|
Definition
|
|
Term
| If binocular, how does APN manifest in the eye with poorer vision |
|
Definition
| Generally worse ie. greater amplitude in the worse eye |
|
|
Term
Acquired vs. Developmental Pendular Nystagmus
Which is more likely to have dissociation between eyes |
|
Definition
|
|
Term
Acquired vs. Developmental Pendular Nystagmus
which is more likely to be vertical or torsional |
|
Definition
|
|
Term
Acquired vs. Developmental Pendular Nystagmus
Which is more likely to have OKN reversal |
|
Definition
|
|
Term
| 3 Forms of Developmental Nystagmus |
|
Definition
Infantile Nystagmus
Latent Nystagmus
Spasmi Nutans |
|
|
Term
| How does the OKN response manifest differently in infantile nystagmus |
|
Definition
| Backwards OKN (quick phases move with drum) |
|
|
Term
| 3 types of nystagmus that are uniplanar |
|
Definition
Infantile Nystagmus
Peripheral Vestibular
PAN |
|
|
Term
| What increases the frequency of Infantile Pendular Nystagmus |
|
Definition
|
|
Term
| Mnemonic for Infantile Nystagmus |
|
Definition
|
|
Term
| What type of astigmatism is expected in infantile nystagmus |
|
Definition
|
|
Term
| If pts with infantile nystagmus present with a head turn, how will you place yoked prism to correct |
|
Definition
Bases towards head turn
ie. apex in the direction you want the head to turn |
|
|
Term
| How does monocular occlusion affect latent-manifest nystagmus |
|
Definition
| It is subclinical binocularly and becomes manifest with occlusion, will also switch direction |
|
|
Term
| What should you look for 'beneath' Latent Manifest Nystagmus |
|
Definition
| Infantile Esotropia and Dissociated Vertical Deviation |
|
|
Term
| When does Spasmus Nutans tend to start showing up |
|
Definition
|
|
Term
| Classic Spasmus Nutans Triad |
|
Definition
Abnormal head position
Head Nodding
Nystagmus |
|
|
Term
| 6 treatment options for Nystagmus (6) |
|
Definition
Botox
Prism
Contact Lenses
Surgery
Oral Meds
Vision Therapy |
|
|
Term
| Which treatment is best for transient nystagmus (caused by a resolving stroke or pituitary tumor) |
|
Definition
|
|
Term
| 3 complications that occurred in botox trials |
|
Definition
Keratitis
External ophthalmoplegia
Blepharoptosis |
|
|
Term
| How long does Botox last for |
|
Definition
|
|
Term
| 3 Most common botox side effects |
|
Definition
Ptosis
Diplopia
Worsened nystagmus in untreated eye |
|
|
Term
| Static Optical Treatment for Nystagmus |
|
Definition
|
|
Term
| Dynamic Optical treatment for nystagmus |
|
Definition
| Contact lenses-rigid or soft |
|
|
Term
| 2 surgical treatments of nystagmus |
|
Definition
Kestenbaum Procedure
Four-Muscle Tenotomy |
|
|
Term
| Which surgery for nystagmus does not actually dampen the nystagmus or increase VA? |
|
Definition
| Kestenbaum-just moves the null point to primary gaze |
|
|
Term
| Which surgery involves recession and resection of rectus muscles to treat nyst |
|
Definition
|
|
Term
| What are the age and head-turn guidelines for recommending Kestenbaum procedure |
|
Definition
Head turn >15 degrees
>4 yo |
|
|
Term
| What non-surgical intervention can produce the same result as the kestenbaum procedure |
|
Definition
|
|
Term
| 4 indications/uses for Acetazolamide |
|
Definition
Open-angle & angle-closure glaucoma
Meniere's disease
Pseudotumor cerebri
Arnold-Chiari malformation |
|
|
Term
| 2 types of nystagmus that can be treated with acetazolamide |
|
Definition
Downbeat nystagmus (since commonly caused by Arnold-Chiari)
Gaze-evoked nystagmus (like in Menieres) |
|
|
Term
| Possible side effect of aminopyradines |
|
Definition
|
|
Term
| Which type of nystagmus is treated with aminopyradine |
|
Definition
|
|
Term
| According to G. Erickson, what is the most commonly prescribed med for acquired nystagmus |
|
Definition
|
|
Term
| Name 5 types of nystagmus that can be treated with Baclofen |
|
Definition
Downbeat
Upbeat
Seesaw
PAN
Torsional |
|
|
Term
| Clonazepam may be used as a second line drug for which type of nystagmus |
|
Definition
|
|
Term
| 4 types of nystagmus treated with clonazepam |
|
Definition
Seesaw
APN (2nd line)
Upbeat
Torsional |
|
|
Term
| Gabapentin is used off-label to treat which 3 forms of nystagmus |
|
Definition
Seesaw
Torsional
APN/Oculopalatal Tremor |
|
|
Term
| Which type of nystagmus is treated with Memantine |
|
Definition
|
|
Term
| What neurotransmitter does Mementine mimic |
|
Definition
|
|
Term
| 2 non-ocular conditions treated with scopolamine |
|
Definition
Parkinsons disease
GI tract spasm |
|
|
Term
| Scopolamine may be used to treat which nystagmus |
|
Definition
|
|
Term
| Which of the discussed meds is a teratogen |
|
Definition
|
|
Term
| Valproate is used to treat which nystagmus |
|
Definition
|
|
Term
| First step in VT skill development for nystagmus treatment |
|
Definition
| Antisuppression and sensory fusion therapy |
|
|
Term
| 2 systemic conditions treated with Aminopyradines |
|
Definition
MS
Lambert-Eaton Myasthenic Syndrome |
|
|
Term
| Non-ocular condition Baclofen is used to treat |
|
Definition
|
|
Term
| Non-ocular condition Clonazapam is used to treat |
|
Definition
|
|
Term
| Non-ocular condition Gabapentin is used to treat |
|
Definition
|
|
Term
| Non-ocular condition Mematine is used to treat |
|
Definition
| Dementia (like Alzheimer's) |
|
|
