Ocular Movement Examination in Peripheral Vestibular Disorders as a Tool to Improve Diagnosis: A Literature Review

Medicina (Kaunas). 2024 Oct 11;60(10):1665. doi: 10.3390/medicina60101665.

Abstract

Background and Objectives: This study reviews the current literature on ocular movements, specifically focusing on nystagmus associated with peripheral vestibular disorders, to enhance diagnostic accuracy. The evaluation of ocular movements, particularly nystagmus, provides essential insights into the function and dysfunction of the vestibular system, helping clinicians distinguish between peripheral and central causes of vertigo and imbalance. Materials and Methods: A comprehensive search of PubMed was conducted using key terms such as "ocular movements", "nystagmus", "vestibular nystagmus", and "peripheral vestibular disorders". Results: The search yielded 2739 titles, and after a rigorous selection process, 52 articles were reviewed in full. Discussion: The review highlights different classifications and types of nystagmus, including physiological and pathological forms, and their diagnostic relevance in vestibular disorders such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, and Meniere's disease. Diagnostic techniques like video/electro-oculography are emphasized for their role in assessing vestibular function and identifying abnormalities. The study underscores the importance of detailed ocular examination in the diagnosis of peripheral vestibular disorders and proposes an algorithm to aid this process. Conclusions: While not a systematic review, this study highlights the importance of detailed ocular examination in diagnosing peripheral vestibular disorders and presents an algorithm to facilitate this process. It also emphasizes the need for continued research and advancements in vestibular medicine to further understand ocular movements and their clinical significance, ultimately contributing to improved patient outcomes.

Keywords: nystagmus; ocular movements; peripheral vestibular nystagmus; vestibular disorder.

Publication types

  • Review

MeSH terms

  • Benign Paroxysmal Positional Vertigo / diagnosis
  • Benign Paroxysmal Positional Vertigo / physiopathology
  • Eye Movements / physiology
  • Humans
  • Meniere Disease / diagnosis
  • Meniere Disease / physiopathology
  • Nystagmus, Pathologic / diagnosis
  • Nystagmus, Pathologic / physiopathology
  • Vestibular Diseases* / diagnosis
  • Vestibular Diseases* / physiopathology
  • Vestibular Neuronitis / complications
  • Vestibular Neuronitis / diagnosis
  • Vestibular Neuronitis / physiopathology

Grants and funding

Publication of this article was supported by the “Carol Davila” University of Medicine and Pharmacy (Bucharest, Romania), through the institutional program “Publish not Perish”.