Nystagmus characteristics of healthy controls

J Vestib Res. 2020;30(6):345-352. doi: 10.3233/VES-200022.


Background: Healthy controls exhibit spontaneous and positional nystagmus which needs to be distinguished from pathological nystagmus.

Objective: Define nystagmus characteristics of healthy controls using portable video-oculography.

Methods: One-hundred and one asymptomatic community-dwelling adults were prospectively recruited. Participants answered questions regarding their audio-vestibular and headache history and were sub-categorized into migraine/non-migraine groups. Portable video-oculography was conducted in the upright, supine, left- and right-lateral positions, using miniature take-home video glasses.

Results: Upright position spontaneous nystagmus was found in 30.7% of subjects (slow-phase velocity (SPV)), mean 1.1±2.2 degrees per second (°/s) (range 0.0 - 9.3). Upright position spontaneous nystagmus was horizontal, up-beating or down-beating in 16.7, 7.9 and 5.9% of subjects. Nystagmus in at least one lying position was found in 70.3% of subjects with 56.4% showing nystagmus while supine, and 63.4% in at least one lateral position. While supine, 20.8% of subjects showed up-beating nystagmus, 8.9% showed down-beating, and 26.7% had horizontal nystagmus. In the lateral positions combined, 37.1% displayed horizontal nystagmus on at least one side, while 6.4% showed up-beating, 6.4% showed down-beating. Mean nystagmus SPVs in the supine, right and left lateral positions were 2.2±2.8, 2.7±3.4, and 2.1±3.2°/s. No significant difference was found between migraine and non-migraine groups for nystagmus SPVs, prevalence, vertical vs horizontal fast-phase, or low- vs high-velocity nystagmus (<5 vs > 5°/s).

Conclusions: Healthy controls without a history of spontaneous vertigo show low velocity spontaneous and positional nystagmus, highlighting the importance of interictal nystagmus measures when assessing the acutely symptomatic patient.

Keywords: Nystagmus; normal control; vertigo; video nystagmography; video oculography.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Eye Protective Devices*
  • Female
  • Healthy Volunteers
  • Humans
  • Male
  • Middle Aged
  • Nystagmus, Pathologic / diagnosis
  • Nystagmus, Pathologic / physiopathology*
  • Nystagmus, Physiologic / physiology*
  • Patient Positioning / instrumentation
  • Patient Positioning / methods*
  • Vestibular Function Tests / instrumentation
  • Vestibular Function Tests / methods*
  • Video Recording / methods*
  • Young Adult