Clinical nystagmus characteristics – distribution of intensity components in acute vertigo patients

Introduction For the evaluation of vestibular function, videonystagmography (VNG) is considered the gold standard in addition to subjective examination with Frenzel glasses. The intensity components are frequency and SPV (slow phase velocity) of the nystagmus. Currently, there are no clear values for the normal distribution of these parameters.

Method 45 patients with subjective acute or recurrent vertigo underwent VNG. The values of frequency and SPV were determined and evaluated if spontaneous nystagmus (SPN) was present.

Results In the cohort of patients, 64% were diagnosed with neuropathia vestibularis (NV), 27% had another ENT diagnosis (vestibular schwannoma, zoster oticus, M. Menière, BPPV), and 9% had a neurological disease. SPN was detected in 82.2% of cases with VNG and in 80% of cases with Frenzel glasses. The frequency of the SPN in these patients was in the low range (<1/s) in 54%, in the medium range (1-2/s) in 32%, and in the high range (>2/s) in 14%, with a mean value of 1.05/s. GLP was distributed among values below 5°/s in 43%, between 5-15°/s in 35%, and >15°/s in 22%, the mean value was 8.82°/s.

Summary A large proportion of the patient cohort showed low-frequency SPN with low SPV, which may complicate subjective diagnosis. Therefore, an instrument-based diagnosis is reasonable. However, patients with NV in particular showed high values for frequency and SPV. A larger cohort is needed to establish a meaningful normal distribution.

Publication History

Article published online:
12 May 2023