Annals of Clinical Neurophysiology

The Korean Society of Clinical Neurophysiology (대한임상신경생리학회)
권호 표지
DOI QR코드

DOI QR Code

Recording and interpretation of ocular movements: spontaneous and induced nystagmus

  • Jin-Ju Kang (Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University School of Medicine) ;
  • Seoyoung Choi (Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute) ;
  • Seunghee Na (Department of Neurology, The Catholic University of Korea Incheon St. Mary's Hospital) ;
  • Sun-Young Oh (Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University School of Medicine)
  • Received : 2022.10.27
  • Accepted : 2023.02.09
  • Published : 2023.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

The ultimate purpose of eye movement is to maintain clear vision by ensuring that images of observed objects are focused on the fovea in the retina. Accurate evaluation of ocular movements, including nystagmus and saccadic intrusions, provides very useful information for determining the overall function and abnormality of the complex oculomotor system, from the peripheral vestibular system to the cerebrum. Eye movement tests are therefore essential for the accurate diagnosis of patients who complain of dizziness and imbalance. They help to predict lesion locations from the peripheral vestibular system to the central cerebral cortex and play an important role in differentiation from other diseases. The methodology of recording and interpreting ocular movements using video-oculography are described in this review article.

Keywords

Acknowledgement

This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (Ministry of Science and ICT) (No. 2022R1A2B5B01001933) and by the Fund of the Biomedical Research Institute, Jeonbuk National University Hospital.

References

  1. Downey DL, Leigh RJ. Eye movements: pathophysiology, examination and clinical importance. J Neurosci Nurs 1998;30:15-22; quiz 23-24. https://doi.org/10.1097/01376517-199802000-00003
  2. Leigh RJ, Zee DS. The neurology of eye movements. 5th. New York: Oxford University Press, 2015;10-12.
  3. Westheimer G. Mechanism of saccadic eye movements. AMA Arch Ophthalmol 1954;52:710-724. https://doi.org/10.1001/archopht.1954.00920050716006
  4. Ilg UJ. Slow eye movements. Prog Neurobiol 1997;53:293-329. https://doi.org/10.1016/S0301-0082(97)00039-7
  5. Tatler BW, Wade NJ. On nystagmus, saccades, and fixations. Perception 2003;32:167-184. https://doi.org/10.1068/p3395
  6. Haslwanter T, Clarke AH. Eye movement measurement: electro-oculography and video-oculography. Handbook of Clinical Neurophysiology 2010;9:61-79. https://doi.org/10.1016/S1567-4231(10)09005-2
  7. Young LR, Sheena D. Survey of eye movement recording methods. Behavior Research Methods & Instrumentation 1975;7:397-429. https://doi.org/10.3758/BF03201553
  8. Robinson DA. A method of measuring eye movemnent using a scieral search coil in a magnetic field. TBME 1963;10:137-145.
  9. Strupp M, Glasauer S, Jahn K, Schneider E, Krafczyk S, Brandt T. Eye movements and balance. Ann N Y Acad Sci 2003;1004:352-358. https://doi.org/10.1196/annals.1303.033
  10. Baloh RW. Differentiating between peripheral and central causes of vertigo. Otolaryngol Head Neck Surg 1998;119:55-59. https://doi.org/10.1016/S0194-5998(98)70173-1
  11. Serra A, Leigh RJ. Diagnostic value of nystagmus: spontaneous and induced ocular oscillations. J Neurol Neurosurg Psychiatry 2002;73:615-618. https://doi.org/10.1136/jnnp.73.6.615
  12. Robinson DA, Zee DS, Hain TC, Holmes A, Rosenberg LF. Alexander's law: its behavior and origin in the human vestibulo-ocular reflex. Ann Neurol 1984;16:714-722. https://doi.org/10.1002/ana.410160614
  13. Strupp M, Hufner K, Sandmann R, Zwergal A, Dieterich M, Jahn K, et al. Central oculomotor disturbances and nystagmus: a window into the brainstem and cerebellum. Dtsch Arztebl Int 2011;108:197-204. https://doi.org/10.3238/arztebl.2011.0197
  14. Tilikete C, Pelisson D. Ocular motor syndromes of the brainstem and cerebellum. Curr Opin Neurol 2008;21:22-28. https://doi.org/10.1097/WCO.0b013e3282f4097d
  15. Keller EL, Heinen SJ. Generation of smooth-pursuit eye movements: neuronal mechanisms and pathways. Neurosci Res 1991;11:79-107. https://doi.org/10.1016/0168-0102(91)90048-4
  16. Bedell HE, Stevenson SB. Eye movement testing in clinical examination. Vision Res 2013;90:32-37. https://doi.org/10.1016/j.visres.2013.02.001
  17. Lang EE, McConn Walsh R. Vestibular function testing. Ir J Med Sci 2010;179:173-178. https://doi.org/10.1007/s11845-010-0465-7
  18. Cannon SC, Robinson DA. Loss of the neural integrator of the oculomotor system from brain stem lesions in monkey. J Neurophysiol 1987;57:1383-1409. https://doi.org/10.1152/jn.1987.57.5.1383
  19. Katsarkas A, Smith H, Galiana H. Head-shaking nystagmus (HSN): the theoretical explanation and the experimental proof. Acta Otolaryngol 2000;120:177-181.
  20. Ohki M, Murofushi T, Nakahara H, Sugasawa K. Vibration-induced nystagmus in patients with vestibular disorders. Otolaryngol Head Neck Surg 2003;129:255-258. https://doi.org/10.1016/S0194-5998(03)00529-1
  21. Barber HO. Positional nystagmus. Otolaryngol Head Neck Surg 1984;92:649-655. https://doi.org/10.1177/019459988409200611
  22. Kavanagh KT, Babin RW. Definitions and types of nystagmus and calculations. Ear Hear 1986;7:157-166. https://doi.org/10.1097/00003446-198606000-00007
  23. Barnes GR. A procedure for the analysis of nystagmus and other eye movements. Aviat Space Environ Med 1982;53:676-682.
  24. Rucker JC. An update on acquired nystagmus. Semin Ophthalmol 2008;23:91-97. https://doi.org/10.1080/08820530801888089
  25. Levo H, Aalto H, Petteri Hirvonen T. Nystagmus measured with video-oculography: methodological aspects and normative data. ORL J Otorhinolaryngol Relat Spec 2004;66:101-104. https://doi.org/10.1159/000079327
  26. Karatas M. Central vertigo and dizziness: epidemiology, differential diagnosis, and common causes. Neurologist 2008;14:355-364. https://doi.org/10.1097/NRL.0b013e31817533a3
  27. Rett D. Gaze-evoked nystagmus: a case report and literature review. Optometry 2007;78:460-464. https://doi.org/10.1016/j.optm.2007.02.016
  28. Abel LA, Dell'osso LF, Daroff RB. Analog model for gaze-evoked nystagmus. IEEE Trans Biomed Eng 1978;25:71-75. https://doi.org/10.1109/TBME.1978.326380
  29. Robinson DA. Eye movement control in primates. The oculomotor system contains specialized subsystems for acquiring and tracking visual targets. Science 1968;161:1219-1224. https://doi.org/10.1126/science.161.3847.1219
  30. Robinson DA. The use of control systems analysis in the neurophysiology of eye movements. Annu Rev Neurosci 1981;4:463-503. https://doi.org/10.1146/annurev.ne.04.030181.002335
  31. Lee H, Kim HA. Anatomical structure responsible for direction changing bilateral gaze-evoked nystagmus in patients with unilateral cerebellar infarction. Medicine (Baltimore) 2020;99:e19866.
  32. Abadi RV. Mechanisms underlying nystagmus. J R Soc Med 2002;95:231-234. https://doi.org/10.1177/014107680209500504
  33. Abel LA, Parker L, Daroff RB, Dell'Osso LF. End-point nystagmus. Invest Ophthalmol Vis Sci 1978;17:539-544.
  34. Stahl JS, Averbuch-Heller L, Leigh RJ. Acquired nystagmus. Arch Ophthalmol 2000;118:544-549. https://doi.org/10.1001/archopht.118.4.544
  35. Eizenman M, Cheng P, Sharpe JA, Frecker RC. End-point nystagmus and ocular drift: an experimental and theoretical study. Vision Res 1990;30:863-877. https://doi.org/10.1016/0042-6989(90)90055-P
  36. Eizenman, M, Sharpe JA. End point, gaze-evoked, and rebound nystagmus. In: Sharpe JA, Barber HO, eds. The vestibulo-ocular reflex and vertigo. New York: Raven Press, 1993;257-267.
  37. Kamei T. Two types of head-shaking tests in vestibular examination. Acta Otolaryngol Suppl 1988;458:108-112. https://doi.org/10.3109/00016488809125112
  38. Asawavichiangianda S, Fujimoto M, Mai M, Desroches H, Rutka J. Significance of head-shaking nystagmus in the evaluation of the dizzy patient. Acta Otolaryngol Suppl 1999;540:27-33. https://doi.org/10.1080/00016489950181152
  39. Minor LB, Haslwanter T, Straumann D, Zee DS. Hyperventilation-induced nystagmus in patients with vestibular schwannoma. Neurology 1999;53:2158-2168. https://doi.org/10.1212/WNL.53.9.2158
  40. Kheradmand A, Zee DS. The bedside examination of the vestibulo-ocular reflex (VOR): an update. Rev Neurol (Paris) 2012;168:710-719. https://doi.org/10.1016/j.neurol.2012.07.011
  41. Parnes LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ 2003;169:681-693.
  42. Schmal F, Stoll W. Diagnosis and management of benign paroxysmal positional vertigo. Laryngorhinootologie 2002;81:368-380. https://doi.org/10.1055/s-2002-34527
  43. Singh J, Bhardwaj B. Lateral semicircular canal BPPV…are we still ignorant? Indian J Otolaryngol Head Neck Surg 2020;72:175-183. https://doi.org/10.1007/s12070-019-01737-4
  44. Vannucchi P, Giannoni B, Pagnini P. Treatment of horizontal semicircular canal benign paroxysmal positional vertigo. J Vestib Res 1997;7:1-6. https://doi.org/10.3233/VES-1997-7101
  45. Kim CH, Kim YG, Shin JE, Yang YS, Im D. Lateralization of horizontal semicircular canal canalolithiasis and cupulopathy using bow and lean test and head-roll test. Eur Arch Otorhinolaryngol 2016;273:3003-3009. https://doi.org/10.1007/s00405-016-3894-8
  46. Macdonald NK, Kaski D, Saman Y, Al-Shaikh Sulaiman A, Anwer A, Bamiou DE. Central positional nystagmus: a systematic literature review. Front Neurol 2017;8:141.
  47. Lemos J, Strupp M. Central positional nystagmus: an update. J Neurol 2022;269:1851-1860. https://doi.org/10.1007/s00415-021-10852-8
  48. Buttner U, Helmchen C, Brandt T. Diagnostic criteria for central versus peripheral positioning nystagmus and vertigo: a review. Acta Otolaryngol 1999;119:1-5. https://doi.org/10.1080/00016489950181855