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CLINICAL SIGN |
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| Year : 2022 | Volume
: 25
| Issue : 1 | Page : 120 |
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Uncovering the fixation suppression of peripheral nystagmus - Poor man's solutions
Thirugnanam Umapathi
National Neuroscience Institute, Singapore
| Date of Submission | 13-Oct-2021 |
| Date of Acceptance | 06-Nov-2021 |
| Date of Web Publication | 14-Feb-2022 |
Correspondence Address:
Thirugnanam Umapathi
National Neuroscience Institute
Singapore
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/aian.aian_910_21
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 |
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 | |  |
| 1. | Dhonde P, Khadilkar S. Frenzel glasses: An affordable alternative. Pract Neurol 2020;20:504.  |
| 2. | Strupp M, Fischer C, Hanß L, Bayer O. The takeaway Frenzel goggles: A fresnel-based devise. Neurology 2014;83:1241-5. |
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