Unilateral rotary nystagmus / Alexander Duane.

  • Alexander Duane
Date:
[1906]
Catalogue details

Licence: In copyright

Credit: Unilateral rotary nystagmus / Alexander Duane. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    f In the right eye no trace of nystagmus; not the slightest oscj tion being detected even with the ophthalmoscope. In the lef^ 63 at times no vibration, at times true nystagmus, consisting of ra 'PidI repeated, short, quick, to-and-fro oscillations. In the primary' Posi tion the nystagmus seems to be sometimes mixed (vertical anc rotary), at other times purely rotary (opposite to the hands of ^ clock). When the eyes are directed to the right, the nystagmus is largely vertical; when they are directed to the left, the nystagmus is slow and mainly rotary. Nystagmus is present also when the eyes are directed up or down. If the head is tilted to right shoulder • marked rotary nystagmus; when head is tilted to left shoulder slow rotary or more marked vertical nystagmus. Nystagmus not ar- . rested by covering either eye and seems rather more marked when : the left eye alone is used for fixing. It is also somewhat greater in forced convergence. No evidence of ear disease beyond a slight catarrhal otitis media. Careful examination by Dr. Joseph Collins shows absolutely no evidence of organic nerve disease nor of disease of any of the organs Examination of the urine shows no abnormality. No evidence of digestive toxfemia. The patient was directed to wear constantly the glasses fully correcting her astigmatism and hj^peropia; to prac- tice convergence by looking sharply at a pinhead gradually approxi- i mated to the eye, and to exercise regularly with a stereoscope 3 (Wells' diagrams). The case is interesting on several accounts: 1. It is an instance of unilateral rotary nystagmus. Unilateral nystagmus itself is rare, only some 50 or 60 cases having been re- ported. Of these the large majority are vertical. In my summary of 52 cases published a year ago,^ I found that 34 were vertical, 11 horizontal, 5 rotary, and 2 mixed. Of the 5 cases of rotary nystag- mus noted in this summary, one occurred in my own practice and was described in the article. It seemed there to form one of the initial symptoms of a general paresis. 2. Thk Symptoms.—These were (a) Apparent oscillating move- ment of objects looked at. This is frequently present in acquired nystagmus and particularly in the unilateral form, (b) A peculiar 1. New York State Journal ot Medicine. July, 1905.
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