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J Am Acad Audiol 2019; 30(10): 883-895
DOI: 10.3766/jaaa.18024
Articles
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Static Positional Nystagmus in the Healthy Vestibular System

Authors

  • M. Dawn Nelson

    *   Department of Communication Sciences and Disorders, Central Michigan University, Mount Pleasant, MI

  • Larissa Mann

    *   Department of Communication Sciences and Disorders, Central Michigan University, Mount Pleasant, MI

  • Christine Nicholson

    *   Department of Communication Sciences and Disorders, Central Michigan University, Mount Pleasant, MI

  • Mark Lehman

    *   Department of Communication Sciences and Disorders, Central Michigan University, Mount Pleasant, MI
Further Information

Publication History

12 April 2018

Publication Date:
25 May 2020 (online)

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Abstract

Background:

A repeat of the seminal 1973 study on static positional nystagmus (PN) using more accurate recording techniques.

Purpose:

The purpose was to further characterize PN and, using current data, introduce new clinical criteria for its identification.

Research Design:

Static PN was recorded in ten positions with vision denied. Each position was analyzed using age, gender, presence, direction, and persistence of nystagmus while taking into account the number of beats and mean slow-phase velocity (SPV).

Study Sample:

One hundred healthy patients who were asymptomatic with no known neurological disorders were tested.

Intervention:

No intervention was used.

Data Collection:

Analysis of variance, descriptive statistics, and confidence intervals were used to describe results.

Results:

Results showed 74% of normal participants had horizontal nystagmus in at least one position. Only 7% of the observed nystagmus was persistent. The average SPV was 2°/sec. The mean number of positions in which nystagmus was observed was three. Neither age nor gender influenced the occurrence of nystagmus. Forty-three percent of the participants had vertical nystagmus in at least one position; however, the SPV was 2°/sec or less.

Conclusions:

The present study demonstrated that intermittent or persistent PN in four or fewer positions should not be considered pathological when the SPV is 4°/sec or less (n = 100). Observance of vertical nystagmus in one position should not be considered pathological if the SPV is 2°/sec or less. Suggested positions for positional testing should include seated-upright, supine, head right, head left, head-hanging, and the precaloric (30° supine) positions. Fixation when PN is observed is indicated.

Key Words

balance - electronystagmography - eye movements - nystagmus - positional nystagmus - static - vestibular - videonystagmography

Larissa Mann is now at the Idaho Elks Hearing and Balance Center, Nampa, Idaho. Christine Nicholson is now at Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.


This project was presented at the American Academy of Audiology Conference (AudiologyNOW!) in Dallas, TX, April 2009.