Topic
Bruns nystagmus
About: Bruns nystagmus is a research topic. Over the lifetime, 15 publications have been published within this topic receiving 89 citations.
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TL;DR: These patients tend to have greater balance impairment pre\operatively, but after surgery, long-term balance outcomes are similar to those of patients with no nystagmus or other forms of nyStagmus.
Abstract: OBJECTIVES To determine the prevalence of Bruns' nystagmus in patients undergoing surgical treatment for unilateral sporadic vestibular schwannomas (VSs), identify the clinical characteristics of patients with Bruns' nystagmus and compare these characteristics with those of VS patients with no nystagmus and other types of nystagmus, and determine the long-term impact of having preoperative Bruns' nystagmus. STUDY DESIGN A retrospective review using a prospectively updated database of patients who had undergone surgical removal of a VS. Patients were divided into 3 groups: Bruns' nystagmus, other types of nystagmus, or no nystagmus. Statistical comparison of each group was undertaken. PATIENTS Nine hundred eighty-four patients were included consisting of 492 men and 492 women with a mean age of 59 years (range, 11-86 yr). RESULTS Bruns' nystagmus was present in 11% of patients. Bruns' nystagmus was associated with larger tumor size (p < 0.001). Beyond 3.5-cm maximum diameter, 92% of patients had nystagmus, 67% of which had Bruns' nystagmus. Preoperative balance impairment was present in 95% of patients with Bruns' nystagmus compared with 59% with no nystagmus. The balance status of all groups improved considerably postoperatively, but the patients with Bruns' nystagmus had a relatively greater improvement in balance status. CONCLUSION Bruns' nystagmus occurs in patients with large VSs. These patients tend to have greater balance impairment pre\operatively, but after surgery, long-term balance outcomes are similar to those of patients with no nystagmus or other forms of nystagmus.
29 citations
TL;DR: It is concluded that Bruns nystagmus occurs in large tumours associated with significant brainstem distortion, and the neurophysiological abnormalities demonstrated by brainstem audiometry appear to be a less sensitive measure of brainstem compression than neuro-anatomical assessment using CT.
Abstract: Bruns nystagmus is an uncommon, bidirectional optokinetic disturbance associated with advanced cerebellopontine angle tumours. In a retrospective analysis of 11 5 such tumours, Bruns nystagmus was observed in 18 patients (16%). All tumours in this group were 3 cm or greater in diameter. Fourth ventricle displacement as assessed by computerized cranial tomography was present in all cases where the fourth ventricle was visualized (89%). Seven of 15 cases (47%) had significant contralateral N5 delay on brainstem auditory evoked potential testing, 5 (33%) were normal and 3 (20%) gave no consistent result. It was concluded that Bruns nystagmus occurs in large tumours associated with significant brainstem distortion. The neurophysiological abnormalities demonstrated by brainstem audiometry appear to be a less sensitive measure of brainstem compression than neuro-anatomical assessment using CT.
23 citations
12 citations
TL;DR: In this article, the authors used video-oculography (VOG) to compare GEN in the light (target at 15° eccentric) in 64 healthy subjects with 47 patients seen in the emergency department (ED) who had AVS; 35 with vestibular neuritis and 12 with stroke.
Abstract: OBJECTIVE Gaze-evoked nystagmus (GEN) is a central sign in patients with the acute vestibular syndrome (AVS); however, discriminating between a pathological and a physiologic GEN is a challenge. Here we evaluate GEN in patients with AVS. METHODS In this prospective cross-sectional study, we used video-oculography (VOG) to compare GEN in the light (target at 15° eccentric) in 64 healthy subjects with 47 patients seen in the emergency department (ED) who had AVS; 35 with vestibular neuritis and 12 with stroke. All patients with an initial non-diagnostic MRI received a confirmatory, delayed MRI as a reference standard in detecting stroke. RESULTS Healthy subjects with GEN had a time constant of centripetal drift >18 s. VOG identified pathologic GEN (time constant ≤ 18 s) in 33% of patients with vestibular strokes, specificity was 100%, accuracy was 83%. Results were equivalent to examination by a clinical expert. As expected, since all patients with GEN had a SN in straight-ahead position, they showed the pattern of a Bruns' nystagmus. CONCLUSIONS One third of patients with AVS due to central vestibular strokes had a spontaneous SN in straight-ahead gaze and a pathological GEN, producing the pattern of a Bruns' nystagmus with a shift of the null position. The localization of the side of the lesion based on the null was not consistent, presumably because the circuits underlying gaze-holding are widespread in the brainstem and cerebellum. Nevertheless, automated quantification of GEN with VOG was specific, and accurately identified patients in the ED with AVS due to strokes.
11 citations
TL;DR: A 9-year-old girl with huge, double arachnoid cysts at the cerebellopontine angle that disappeared after a cyst-peritoneal shunt operation developed fine, high-frequency gaze nystagmus towards the lesion side combined with coarse, large amplitude nySTagmus in the opposite direction, which is the reverse of the Bruns' nyStagmus.
Abstract: A 9-year-old girl with huge, double arachnoid cysts at the cerebellopontine angle is reported. After a cyst-peritoneal shunt operation, she developed fine, high-frequency gaze nystagmus towards the le
10 citations