Optokinetic nystagmus: six practical uses

David Edward Hale; Stephen Reich; Dan Gold

doi:10.1136/pn-2023-003772

Optokinetic nystagmus: six practical uses

Pract Neurol. 2024 Mar 20:pn-2023-003772. doi: 10.1136/pn-2023-003772. Online ahead of print.

Authors

David Edward Hale¹, Stephen Reich², Dan Gold^{3

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Affiliations

¹ Neurology, Johns Hopkins University, Baltimore, Maryland, USA dhale12@jh.edu.
² Neurology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
³ Neurology, Johns Hopkins University, Baltimore, Maryland, USA.
⁴ Neurosurgery, Johns Hopkins University, Baltimore, Maryland, USA.
⁵ Ophthalmology, Johns Hopkins University, Baltimore, Maryland, USA.
⁶ Otolaryngology - Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
⁷ Emergency Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
⁸ Medicine, Johns Hopkins University, Baltimore, Maryland, USA.

PMID: 38508722
DOI: 10.1136/pn-2023-003772

Abstract

Optokinetic nystagmus (OKN) is a reflexive eye movement in response to movement of the viewer's visual environment that consists of a slow phase eye movement in the direction of the stimulus followed by a quick phase in the opposite direction. When tested at the bedside, the slow phases represent smooth pursuit, while the quick phases represent saccades. Normally, OKN is conjugate and symmetric (horizontally and vertically). Abnormalities in the optokinetic response can provide diagnostic and localising value. We describe six clinical scenarios where OKN testing is most useful for the practising neurologist.

Keywords: EYE MOVEMENTS; MOVEMENT DISORDERS; NEUROOPHTHALMOLOGY; NEUROOTOLOGY.