Nystagmus (jerky horizontal)
Jerky horizontal nystagmus occurs when the oscillations are in a horizontal direction.
Causes include:
- vestibular lesion:
- nystagmus away from the side of the lesion
- cerebellar lesion:
- unilateral cerebellar disease causes nystagmus to the side of the lesion
- toxic causes e.g. phenytoin and alcohol
- internuclear ophthalmoplegia:
- in this case, nystagmus is greater in the abducting eye with failure of adduction on the affected side
- due to a lesion in the medial longitudinal fasciculus
- Wernicke's encephalopathy
The commonest cause of unilateral nystagmus is multiple sclerosis.
The commonest cause of bilateral nystagmus is vascular disease.
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