Bruns Nystagmus (During Video-Oculography) Due to Vestibular Schwannoma

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Identifier Bruns_nystagmus_during_video-oculography_due_to_vestibular_schwannoma
Title Bruns Nystagmus (During Video-Oculography) Due to Vestibular Schwannoma
Creator Olwen Murphy, MD; Daniel R. Gold, DO
Affiliation (OM) Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, Maryland; (DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland
Subject Jerk Nystagmus; Gaze-Evoked Nystagmus; Vestbular Nystagmus; Eighth Cranial Nerve; Vestibulocochlear Nerve; Cerebellar OMS
Description A 25-year-old man with a history of right-sided hearing loss, headaches and imbalance was found to have a right vestibular schwannoma on MRI, and underwent a partial resection and radiotherapy. He denied symptoms of head movement dependent oscillopsia (i.e., suggestive of significant unilateral or bilateral vestibular loss), but did experience oscillopsia when looking to the right (absent head movement). With fixation, there was subtle spontaneous left-beating nystagmus (LBN) in primary position and in up and down gaze, increasing in left gaze in accordance with Alexander's law, consistent with vestibular nystagmus due to the right vestibulopathy (from the schwannoma). This vestibular nystagmus was high frequency and small amplitude. In right gaze, there was low frequency, large amplitude right-beating nystagmus (RBN), consistent with gaze-evoked nystagmus due to dysfunction of the gaze-holding mechanism (neural integrator) from right posterior fossa compression (especially the cerebellar flocculus based on MRI). The combination of contralesional (LBN) vestibular nystagmus and ipsilesional (RBN) gaze-evoked nystagmus is characteristic of cerebellopontine angle pathology, and is termed Bruns nystagmus. 1
Date 2021-05
References Lloyd SK, Baguley DM, Butler K, et al. Bruns' nystagmus in patients with vestibular schwannoma. Otol Neurotol. 2009;30(5):625-8. doi: 10.1097/MAO.0b013e3181a32bec.
Language eng
Format video/mp4
Type Image/MovingImage
Collection Neuro-Ophthalmology Virtual Education Library: Dan Gold Collection: https://novel.utah.edu/Gold/
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management Copyright 2016. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6gr2wv5
Setname ehsl_novel_gold
ID 1696151
Reference URL https://collections.lib.utah.edu/ark:/87278/s6gr2wv5
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