Revisión sobre la importancia clínica del nistagmo espontáneo y de la prueba de agitación cefálica.

Abstract

Introduction and objective: Clinical otoneurological examination is usually initiated by oculomotor examination. This exploration allows us to evaluate static signs, such as spontaneous nystagmus, and dynamic signs such as post head-shaking nystagmus, mastoid vibration nystagmus or oculocephalic impulse test. The objective of this review will be to expose the physiopathological bases of spontaneous nystagmus and the head-shaking test as well as its clinical utility. Method: It is a narrative review where we select the bibliography that we consider most relevant for this objective. Results: We describe nystagmus as the involuntary and rhythmic movement of the eyes which appears spontaneously or provoked by different stimuli. The exploration of spontaneous nystagmus in the 5 positions of the look, as well as its characteristic, is the fundamental tool in the initial assessment of a dizzy patient, followed by performing different maneuvers that can make it to manifest or to modify. Conclusion: The appearance of a spontaneous nystagmus of peripheral characteristics in the context of an acute unilateral vestibulopathy together with the progression of the dynamic signs, are indicators of the clinical situation of the patient and the degree of vestibular compensation.