The spectrum of nystagmus following cerebro-vascular accident

Abstract

Aim: To report the features of nystagmus documen­ted following a confirmed diagnosis or cerebro­vascular accident (stroke). Methods: A multi-centre prospective observational study was undertaken in 14 acute Trust hospitals. Stroke survivors with suspected visual difficulty were recruited. Standardised screening/referral forms and investigation forms were employed to document data on visual impairment, specifically assessment of visual acuity, ocular pathology, eye alignment and movement, visual perception (including Inattention) and visual field defects. Results: Of 323 patients, 38 were found to have nystagmus following cortical, brain stem or cerebel­lar stroke. Twenty were male and 18 female, with a mean age of 65 years. Acquired nystagmus accounted for 84% of the types documented. Four patients had oscillopsia and 3 had vertigo. Associated ocular motility deficits were found in 84% of patients and treatment was largely aimed at alleviating diplopia but also reading difficulties or blurred vision. Improvement was noted in 42%. Conclusion: Twelve per cent of stroke survivors with suspected visual difficulties had nystagmus documen­ted. Most had associated ocular motility defects. Symptoms relating to the nystagmus of oscillopsia and vertigo were reported in 18%. Improvement of ocular motility was recorded in 42%.