How is an oculomotor exam used in a dizziness evaluation?

Updated: Jun 26, 2018
  • Author: Wayne T Shaia, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Oculomotor examination

  • Assess for an internuclear ophthalmoplegia and gaze-dependent nystagmus. Nystagmus of peripheral (ie, labyrinthine) origin typically is unidirectional. Looking in the direction of the fast phase of nystagmus and preventing visual fixation with +20 lenses exaggerate the nystagmus.

  • Nystagmus of brainstem or cerebellar (ie, central) origin may be bidirectional and have more than one direction, eg, torsional plus horizontal movement. Pure vertical nystagmus almost always is a sign of brainstem disease and not a labyrinthine disorder.

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