The interpretation of static positional nystagmus in a balance clinic

Int J Audiol. 2017 Dec;56(12):958-966. doi: 10.1080/14992027.2017.1357841. Epub 2017 Sep 1.


Objective: To review the current criteria for the interpretation of positional nystagmus (PN).

Design: Videonystagmography data on PN was collected for 90 patients presenting for balance testing with a history of vertigo or imbalance (excluding those diagnosed with benign paroxysmal positional vertigo). These were compared to normative data from 90 asymptomatic subjects. A literature review was carried out regarding threshold criteria for clinically significant PN. These were evaluated using the data collected.

Study sample: Clinic group: 90 patients; 37 male, 53 female. Age range 15-82 years. Normative group: Ninety subjects; 31 male, 59 female. Age range 21-79 years.

Results: PN was seen in 75.6% of the clinic group and in 50% of the normative group. The prevalence of nystagmus of slow phase velocity (SPV) > 3°/s was significantly higher in the clinic group than the normative group. The maximum SPV recorded in each position was greater from the clinic group than the normative group.

Conclusions: This study supports the use of normative thresholds for SPV for both horizontal and vertical PN. A normative threshold of >3°/s for horizontal and >7°/s for vertical nystagmus is proposed.

Keywords: Static; VNG; balance; nystagmus; positional; vestibular.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nystagmus, Physiologic*
  • Outpatient Clinics, Hospital*
  • Postural Balance*
  • Predictive Value of Tests
  • Prevalence
  • Vestibular Diseases / diagnosis*
  • Vestibular Diseases / epidemiology
  • Vestibular Diseases / physiopathology
  • Vestibular Function Tests / methods*
  • Vestibule, Labyrinth / physiopathology*
  • Wales / epidemiology
  • Young Adult