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Nystagmus (jerky horizontal)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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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