Department of Neurology, University Hospital Zurich.
University of Zurich, Zurich, Switzerland.
Curr Opin Neurol. 2018 Feb;31(1):74-80. doi: 10.1097/WCO.0000000000000517.
The clinical and laboratory assessment of nystagmus in patients with neurologic disorders can provide crucial elements for a state-of-the-art differential diagnosis. An increasing number of publications in the fields of neuro-otology and neuro-ophthalmology have nystagmus in the center of interest, which makes frequent updates on the diagnostic and therapeutic relevance of these contributions indispensable. This review covers important clinical studies and studies in basic research relevant for the neurologist published from January 2016 to August 2017.
Current themes include vestibular nystagmus, positional nystagmus, optokinetic nystagmus and after-nystagmus, vibration-induced nystagmus, head-shaking nystagmus, postrotatory nystagmus, caloric nystagmus, nystagmus in cerebellar disorders, differential diagnosis of nystagmus and treatment approaches (whereas infantile nystagmus syndrome is not addressed in this review). These studies address mechanisms/pathomechanisms, differential diagnoses and treatment of different forms of nystagmus.
In clinical practice, a structured description of nystagmus including its three-dimensional beating direction, trigger factors and duration is of major importance. The differential diagnosis of downbeat nystagmus is broad and includes acute intoxications, neurodegenerative disorders and cerebrovascular causes amongst others. In patients with positional nystagmus, the distinction between frequent benign peripheral and rare but dangerous central causes is imperative.
神经疾病患者的眼球震颤的临床和实验室评估可为最新的鉴别诊断提供重要依据。神经耳科学和神经眼科学领域的越来越多的出版物都将眼球震颤作为研究的重点，这使得对这些贡献的诊断和治疗相关性的频繁更新变得不可或缺。本综述涵盖了 2016 年 1 月至 2017 年 8 月期间发表的与神经科医生相关的重要临床研究和基础研究。
当前的主题包括前庭性眼球震颤、位置性眼球震颤、视动性眼球震颤和继发性眼球震颤、振动诱导性眼球震颤、摇头性眼球震颤、旋转后性眼球震颤、冷热水试验性眼球震颤、小脑疾病的眼球震颤、眼球震颤的鉴别诊断和治疗方法（而婴儿眼球震颤综合征不在本综述范围内）。这些研究涉及不同类型眼球震颤的机制/病理机制、鉴别诊断和治疗方法。
在临床实践中，对眼球震颤进行包括其三维跳动方向、触发因素和持续时间的结构化描述非常重要。下跳性眼球震颤的鉴别诊断范围很广，包括急性中毒、神经退行性疾病和脑血管疾病等。对于位置性眼球震颤患者，必须区分常见的良性周围性和罕见但危险的中枢性病因。
