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Vestibular nystagmus causes rapid involuntary eye movements due to disruptions in signal pathways between the eyes, inner ear, and brain. It can be peripheral or central and caused by infections, injuries, or diseases. Treatment includes medication and physical therapy.
Individuals with vestibular nystagmus experience rapid involuntary eye movements triggered by a disruption in the signal pathways between the eyes, inner ear, and brain. Vestibular nystagmus can be further divided into the categories of peripheral or central, depending on the particular location of the problem causing the disorder. Eye movements can occur horizontally, vertically, or in a rotational pattern. Infections, injuries, and disease processes including multiple sclerosis can cause the optical disorder. The medications used for treatment may resolve the underlying conditions or provide general relief of symptoms.
The semicircular canals, deep inside the ear, monitor the body’s physical position in space, sending signals to the brain when changes in position occur. The brain responds by altering posture to ensure balance and stability. The nerves that regulate vision also receive signals from the channels and transfer them to the brain when head position changes. Doctors refer to this function as the vestibulo-ocular reflex (VOR). When abnormalities occur in the channels, the brain receives inappropriate signals that can affect eye movement and vision.
Peripheral vestibular nystagmus generally occurs due to malfunctions within the inner ear. Signal obstruction in one or both semicircular canals causes horizontal jerky movements of the eyes. If only one canal is affected, the eyes veer in that direction. Problems that arise in both channels cause the eyes to move back and forth horizontally. Depending on the severity of the abnormality, individuals may experience dizziness, nausea, and balance problems along with nystagmus.
Tiny crystals of calcium carbonate adhere to certain delicate membranes in the ear. Occasionally, these crystals become detached due to normal aging, infection, or head trauma. The objects then wander to other areas of the inner ear as head movement occurs. The displaced crystals interfere with nerve tissue and disrupt signals sent to the brain, causing nystagmus.
Central vestibular nystagmus occurs due to abnormalities that occur at the receiving end of signal transmissions in the brain. Other types of nystagmus related to cranial anomalies include downward gaze, upbeat, and see-saw nystagmus, which describe the direction of eye movement and can provide a clue as to the location of the affliction. Symptoms of nystagmus originating from a brain malfunction include rapid eye movements in horizontal, vertical, or circular motions. A number of disorders, including brain swelling, multiple sclerosis, and tumors, contribute to central vestibular nystagmus.
Ophthalmology specialists diagnose the disorder by monitoring eye movement as a patient performs basic vision exercises. Doctors can do electronystagmography, which records eye movement during the test. Reversing the underlying infection or irritation can correct vestibular nystagmus, and treating nystagmus may include taking antiemetic, anti-inflammatory, anticholinergic, or other medications, which slow signal transmission and brain response. Patients can also undergo a type of physical therapy that retrains the brain’s response to inappropriate signals.
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