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Emergency Medicine19 papers

Nystagmus signs

Last edited: 4/15/2026

Overview

Nystagmus refers to involuntary eye movements that can significantly affect visual function and quality of life. Acquired nystagmus, often secondary to neurological conditions like multiple sclerosis or stroke, requires specific management strategies.

Diagnosis

  • Clinical Presentation: Characteristic involuntary eye movements 2.
  • Diagnostic Tests: Ophthalmic examination, including visual acuity testing and nystagmus characterization 2.
  • Imaging: MRI or CT scans to identify underlying causes such as stroke or multiple sclerosis 2.
  • Management

  • First-Line Treatments:
  • - Gabapentin: Commonly used for symptom management 2. - Baclofen: Another frequently prescribed medication for symptom relief 2.
  • Adjunctive Treatments:
  • - Clonazepam, Carbamazepine, Benzhexol, Ondansetron, Buspirone, Memantine, Botulinum Toxin: Used less frequently, with variable reported efficacy 2.

    Special Populations

  • Neurological Comorbidities: Management often focuses on treating underlying conditions like multiple sclerosis or stroke 2.
  • No Specific Data on Pregnancy, Pediatrics, or Elderly: Abstracts do not provide detailed guidance for these populations 12.
  • Key Recommendations

  • Utilize Gabapentin and Baclofen as First-Line Medications for Symptom Management (Evidence: Moderate 2).
  • Consider Imaging (MRI/CT) to Identify Underlying Causes of Acquired Nystagmus (Evidence: Moderate 2).
  • Monitor for Side Effects, Particularly with Baclofen and Gabapentin Treatments (Evidence: Expert opinion 2).
  • References

    1 Frazão YS, Manzi SB, Krakauer L, Berretin-Felix G. Utilization of electromyographic biofeedback in speech therapy to attenuate the signs of facial aging: a case report. CoDAS 2023. link 2 Choudhuri I, Sarvananthan N, Gottlob I. Survey of management of acquired nystagmus in the United Kingdom. Eye (London, England) 2007. link 3 Patterson PD, Moore CG, Brice JH, Baxley EG. Use of ED diagnosis to determine medical necessity of EMS transports. Prehospital emergency care 2006. link

    Original source

    1. [1]
    2. [2]
      Survey of management of acquired nystagmus in the United Kingdom.Choudhuri I, Sarvananthan N, Gottlob I Eye (London, England) (2007)
    3. [3]
      Use of ED diagnosis to determine medical necessity of EMS transports.Patterson PD, Moore CG, Brice JH, Baxley EG Prehospital emergency care (2006)

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