Nystagmus
Telling peripheral from central nystagmus, the localising patterns (downbeat, upbeat, pendular, periodic alternating, INO), positional nystagmus in BPPV, drug causes and treatment.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Nystagmus is a rhythmic oscillation of the eyes with a slow drift and, in jerk nystagmus, a fast corrective phase. It's named after the fast phase.
- The main exam question: peripheral or central? Central signs point to the brainstem or cerebellum and, in acute vertigo, to stroke.
- Downbeat localises to the craniocervical junction or flocculus, upbeat to the medulla or midbrain, see-saw to the parasellar region, and convergence-retraction to the dorsal midbrain.
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Sources
- Therapeutic Guidelines: NeurologyAU/NZTherapeutic Guidelines Limited
- Classification of vestibular signs and examination techniques: nystagmus and nystagmus-like movementsBárány Society (Journal of Vestibular Research), 2019
- HINTS to diagnose stroke in the acute vestibular syndromeStroke, 2009
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy