Our discussion forums are available to anyone to read, but you must be a member to reply or start new topics. Log-in or register to get started.


Hi Alyson,
Are you working through the “Diagnosing BPPV: Interpreting Nystagmus” tutorial or the “Diagnosing BPPV: Bonus Videos”?

Since you refer to looking at only one eye, I am assuming it is the “Diagnosing BPPV: Interpreting Nystagmus” tutorial (case 3 on the bonus videos is a binocular video) – and I think you might actually have it mostly figured out. We are looking at the patient’s LEFT eye in this video. As you could tell the nystagmus is torsional and upbeating. On our screens, the fast phase is going to the right, which is the patient’s left. The patient has upbeating and left torsional nystagmus, consistent with left posterior canal involvement.

This nystagmus is more subtle than some of the other examples. Finding a specific point on the patient’s eye can lend some clarity on what is actually happening. In this case, I think some of the markings right around the pupil are the easiest to identify the nystagmus’ characteristics.

You can think of it as clockwise and counterclockwise, but this can easily be converted to left/right (personally, I find it simpler to think in terms of left/right). CW/CCW would still be from the patient’s vantage point. Clockwise nystagmus would be torsional with the fast phase to the patient’s right. Counterclockwise would be torsional with the fast phase to the patient’s left. This patient has CCW upbeating nystagmus.