Assessing for hyperventilation-induced nystagmus

Update item information
Identifier Hyperventilation_voice_over
Title Assessing for hyperventilation-induced nystagmus
Subject Hyperventilation
Creator Tony Brune, DO, Department of Neurology, The Johns Hopkins School of Medicine; Daniel R. Gold, DO, Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine
Description Hyperventilation induced nystagmus is tested by asking the patient to take quick deep breaths (~1/s) for 40-60 seconds. This decreases ICP and increases CSF pH. This can be helpful in diagnosing irritative conditions of the vestibular nerve, including an acoustic neuroma (see video, or neurovascular compression (vestibular paroxysmia). With these irritative disorders, nystagmus is usually in an excitatory pattern with contralateral slow phases and fast phases directed toward the side of the lesion (in contrast to a paretic or inhibitory pattern where the slow phase is ipsilesional). Hyperventilation can also accentuate the nystagmus of unilateral vestibular loss due to transient central decompensation. In cerebellar disease (e.g., spinocerebellar ataxia), a downbeat nystagmus may be provoked or accentuated due to pH-induced exacerbation of cerebellar Purkinje fiber calcium channel dysfunction.
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2018-01
Type Image/MovingImage
Format video/mp4
Relation is Part of NOVEL: Neuro-ophthalmology Virtual Education Library Examination Collection
Rights Management Copyright 2018. For further information regarding the rights to this collection, please visit:
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E, SLC, UT 84112-5890
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Language eng
ARK ark:/87278/s6pz98ht
Setname ehsl_novel_gold
Date Created 2018-03-19
Date Modified 2021-05-06
ID 1307319
Reference URL
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