Nystagmus: The Daily PANCE Blueprint

Home Nystagmus: The Daily PANCE Blueprint

Nystagmus: The Daily PANCE Blueprint

A 48-year-old male with a long history of alcohol use presents to the ER with confusion and difficulty walking. On physical examination, he has an unsteady gait and abnormal eye movements when asked to look to the side. You suspect Wernicke’s encephalopathy. Which type of nystagmus is most commonly associated with this condition?

A. Torsional nystagmus
B. Gaze-induced horizontal nystagmus or vertical nystagmus
C. Pure pendular nystagmus
D. Downbeat nystagmus only
E. Mixed torsional–pendular nystagmus

Answer and topic summary

The answer is B. Gaze-induced horizontal nystagmus or vertical nystagmus

Nystagmus is defined as twitching, repetitive, and involuntary movement of both or one eye. There are several different types (torsional, mixed, horizontal, jerk, pendular, and vertical). Etiologies include vestibular neuritis, labyrinths, migraines, strokes, Wernicke’s encephalopathy, multiple sclerosis, phencyclidine (PCP), alcohol, sedatives, myasthenia gravis, etc. A classic test question is how Wernicke’s encephalopathy can cause gaze-induced horizontal/vertical nystagmus. It’s important to note that PURE downbeat, horizontal, or upheld nystagmus is almost nearly always due to a central lesion. A neurology referral/consult should be made.

View blueprint lesson

Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint EENT ⇒ Disorders of the Eye ⇒ Neuro-ophthalmologic disorders => Nystagmus

Sign up for the ENTIRE Blueprint Daily Email Series (1000 daily questions. . . and counting! 😀)

Sign Up
X

Have you tried the NEW Smarty PANCE QBANK? It's FREE with EVERY membership purchase 😀!

Meet the new QBank! 👈
X