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CLINICAL SIGN
Year : 2022  |  Volume : 25  |  Issue : 1  |  Page : 120
 

Uncovering the fixation suppression of peripheral nystagmus - Poor man's solutions


National Neuroscience Institute, Singapore

Date of Submission13-Oct-2021
Date of Acceptance06-Nov-2021
Date of Web Publication14-Feb-2022

Correspondence Address:
Thirugnanam Umapathi
National Neuroscience Institute
Singapore
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aian.aian_910_21

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How to cite this article:
Umapathi T. Uncovering the fixation suppression of peripheral nystagmus - Poor man's solutions. Ann Indian Acad Neurol 2022;25:120

How to cite this URL:
Umapathi T. Uncovering the fixation suppression of peripheral nystagmus - Poor man's solutions. Ann Indian Acad Neurol [serial online] 2022 [cited 2022 May 19];25:120. Available from: https://www.annalsofian.org/text.asp?2022/25/1/120/337567




I discuss simple and practical ways to remove visual fixation when attempting to confirm peripheral nystagmus at the bedside, negating the need for expensive and cumbersome Frenzel goggles. Similar techniques have been described.[1],[2]

Video 1 [Additional file 1] shows a lady with acute left vestibular neuronitis. Her subtle right beating primary position nystagmus is more pronounced when visual fixation is removed using a pair of spectacles with high-dioptre lens. Another trick is to ask the patient to gently shut the eye lids. Some patients, like this man with acute left vestibular neuronitis Video 2 [Additional file 2], have thin enough eyelids to discern the enhancement of nystagmus that occurs from removal of visual fixation. Observing for worsening of nystagmus in a darkened room is also useful.

I call these bedside manoeuvres 'poor man's Frenzels'. The sensitivity of these methods, compared to that of standard Frenzel goggles, has not been studied. Nevertheless, I have employed them for about 10 years and found them valuable for the bedside evaluation of acute vertiginous patients, especially in under-resourced settings.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Dhonde P, Khadilkar S. Frenzel glasses: An affordable alternative. Pract Neurol 2020;20:504.  Back to cited text no. 1
    
2.
Strupp M, Fischer C, Hanß L, Bayer O. The takeaway Frenzel goggles: A fresnel-based devise. Neurology 2014;83:1241-5.  Back to cited text no. 2
    




 

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