(DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland
Subject
Torsional nystagmus
Description
Pure torsional nystagmus typically indicates a brainstem lesion, and is a worrisome sign. The nystagmus should be named for the ear (or shoulder) to which the top poles of the eyes beat - e.g., in this patient, the top poles are always beating toward the right ear, regardless of the direction of gaze. Consider a medullary or midbrain (e.g., interstitial nucleus of Cajal, rostral interstitial medial longitudinal fasciculus) localization.
