nystagmus

Introduction

Introduction to nystagmus Nysttagmus, referred to as nystagmus. It is an involuntary, rhythmic, eye-swinging movement. Often caused by diseases of the visual system, extraocular muscles, inner ear labyrinth and central nervous system. The nystagmus can be divided into two categories according to the etiology, clinical features and related neuro-ophthalmology: 1. sensory defect nystagmus (sensorydefectnystagmus) such as gaze nystagmus; 2. motor-deficient nystagmus (motordefectnystamgus) such as gaze paralysis Nystagmus. The nystagmus is divided into a jump type and a swing type. 1. Bounce type: The eyeball has a reciprocating motion with different speeds. When the eyeball slowly turns to plus one direction and reaches a certain level, it suddenly returns with a slamming movement. Therefore, this type of tremor has a chronic and pleasing performance, chronic The physiological phase, the fast phase is the corrective movement of the slow phase, and the fast phase is the direction of the nystagmus, and the fast phase is related to the cause. 2, swing type: the eyeball swings like a pendulum, there is no fast phase and slow phase, its speed and amplitude are equal, more common in both eyes and patients with amblyopia. basic knowledge The proportion of illness: 0.002% Susceptible people: no special people Mode of infection: non-infectious Complications: strabismus, amblyopia, common strabismus

Cause

Cause of nystagmus

Retinal or refractive medium lesions (20%):

Congenital cataract, choroiditis, opacity or ametropia of the central cornea cause adolescent amblyopia, although some of the visual acuity is preserved, but the eyeball can not be fixed fixation, can cause swaying nystagmus. Long-term in poor light, eyeball fixation obstacles, there may also be shaking and shaking, called "occupational or miner" nystagmus, and may be accompanied by head tremor and levator tendon.

Central lesions (30%):

Central lesions can cause horizontal, rotational or vertical tremor. Some people call vertical tremor as a feature of brain stem disease, but vertical tremor can also occur in brain stem compression or deformation or anti-tuberculosis drug poisoning. Mainly with tremor tremor.

Congenital and familial nystagmus (15%):

It usually occurs shortly after birth and lasts for a lifetime. The genetic form is autosomal dominant or sexual recessive inheritance. When the patient's eyeball is at rest, there is a slight tremor, and the tremor increases regardless of the direction of movement. It may be accompanied by head vibration or jogging, but the patient has no self-conscious symptoms, and there is no nystagmus in the mirror. However, the beating of the eyeballs of other congenital nystagmus patients can be found (due to the different frequencies of the two).

Prevention

Ocular tremor prevention

(1) Prevent infection, control inflammation, stop bleeding, and relieve pain.

(2) Incision from the limbus or ciliary body flat part, after 1 to 2 days of rest, check the anterior and fundus of the eye, such as the anterior chamber has formed, or there is no abnormality in the fundus, you can get out of bed.

(3) Surgery through the retinal incision, the recumbent 4 to 10 days to prove no retinal detachment, before going out of bed and open the eye.

(4) Those who enter the cataract surgery or the vitrectomy at the same time are treated according to the postoperative routine of these operations.

(5) postoperative attention to observe the occurrence of common complications such as vitreous hemorrhage, anterior chamber hemorrhage, vitreous organogenesis, retinal detachment, and if it occurs, it should be treated according to each disease.

(6) Patients who have dropped foreign bodies through the retina incision can not do heavy physical labor within 6 months after surgery to avoid vibration and intense activities.

Complication

Ocular tremor complications Complications strabismus amblyopia common strabismus

The most common complications of nystagmus are: amblyopia, side vision, and strabismus. As for side view, it is actually the reverse performance of the compensation head position. For example, when the contemporary position is for the left turn, the eyes must turn right and sideways. Regarding strabismus, according to statistics, the complication accounted for 21.1%, and the common exotropia was more, accounting for 60.6% of the patients with strabismus, the common slanting accounted for 30.0%, and the upper slanting accounted for 1.4%.

Symptom

Symptoms of nystagmus Common symptoms Vestibular reflex disappears hearing loss, eyelid ptosis... Physiological tremor eyeball convergence function hemp... Dizziness

1. Bounce type: The eyeball has a reciprocating motion with different speeds. When the eyeball slowly turns to plus one direction and reaches a certain level, it suddenly returns with a slamming movement. Therefore, this type of tremor has a chronic and pleasing performance, chronic The physiological phase, the fast phase is the corrective movement of the slow phase, and the fast phase is the direction of the nystagmus, and the fast phase is related to the cause.

2, swing type: the eyeball swings like a pendulum, there is no fast phase and slow phase, its speed and amplitude are equal, more common in both eyes and patients with amblyopia.

Examine

Examination of nystagmus

First, the general inspection

Directly observe the nystagmus when the patient looks straight ahead or causes the patient to follow the examiner's finger in a certain direction. Some need to be covered by a single eye to check. For this reason, the following points should be noted when checking:

1, is recessive or latent or dominant nystagmus.

2, nystagmus is a combination - the movement of the two sides of the eyeball is consistent with each other, or separation.

3. Type, direction, degree, frequency, amplitude, etc. of nystagmus.

4, there is no end of the eye position.

Second, special inspection

Equipment inspection such as nystagmus current map.

Diagnosis

Diagnosis of nystagmus

diagnosis

Ocular tremor refers to the involuntary rhythmic round-trip movement of the eyeball that can be diagnosed as nystagmus.

First, the direction of nystagmus

1, generally according to the direction of nystagmus can be divided into: 1) horizontal nystagmus: refers to the left and right movement of the eyeball; 2) vertical nystagmus: refers to the eyeball up and down movement; 3) rotating nystagmus: the eyeball along its front and rear axis for repeated rotation ; 4) oblique or mixed nystagmus.

2, according to its form can be divided into: 1) oscillating nystagmus: the speed of the eyeball moving back and forth in both directions is equal; 2) impulsive nystagmus (beating): refers to the eyeball back and forth movement in a certain direction is fast Slow in the other direction. That is, there are points of speed:

1) Mixed nystagmus: impulsive nystagmus when the anterior vision is oscillating nystagmus; 2) Irregular nystagmus: the amplitude of the directional movement is irregular.

Second, the speed of nystagmus

According to the speed of nystagmus, it can be divided into: 1) slow: 10-40 times per minute; 2) medium speed: 40-100 times per minute; 3) fast: more than 100 times per minute.

Third, the extent of nystagmus

According to the amplitude of nystagmus, it can be divided into: 1) small: the eyeball offset is within 1mm within 5 degrees; 2) medium: the eyeball is offset by 5-15 degrees between 1-3mm; 3) coarse: eyeball shift The amplitude above 15 degrees is above 3mm. In most cases, nystagmus is a coordinated tremor of the bilateral eyeballs, ie symmetrical as parallel. In the brain stem, there may be a single eye tremor and the other eye tremor is not obvious, that is, a astigmatic nystagmus.

Identification

Mainly differentiated from rickets and peripheral vertigo.

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