👀 Subtle spontaneous nystagmus? The head-shaking test is an essential clinical tool. This patient presented with mild vestibular symptoms, and spontaneous nystagmus was barely visible on initial inspection. After performing the head-shaking test (20 cycles at approximately 2 Hz), we were able to accentuate the underlying nystagmus, making it significantly easier to identify the pattern and laterality. 🔍 Why does this work? Head shaking fatigues the velocity storage mechanism and unmasks asymme

Nystagmus can be physiological (normal) or pathological (abnormal). There are several types of pathological nystagmus. The three types of pathological nystagmus clinicians should be familiar with include spontaneous, gaze-evoked, and positional. - Spontaneous Nystagmus (SN) is present without visual or vestibular provocation. - Gaze-Evoked Nystagmus (GEN) is present in specific gaze directions and occurs 30 degrees or less from head-centered gaze. - Positional Nystagmus (PN) is present in specif