Table of Contents
Advances in Otolaryngology
Volume 2016, Article ID 6974836, 10 pages
Research Article

Positional Nystagmus in Patients Evaluated for Dizziness and Imbalance

1Alabama Hearing & Balance Associates, Inc., Foley, AL 36535, USA
2Associated Audiologists, Shawnee Mission, KS 66204, USA
3The American Institute of Balance, Largo, FL 33777, USA

Received 31 August 2015; Accepted 3 January 2016

Academic Editor: Sampath Prasad

Copyright © 2016 Richard A. Roberts et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


There is variability in the literature regarding the presence of positional nystagmus in healthy participants with reportedly normal vestibular and central nervous system function. This ranges from 7.5% to 88% and raises an important clinical question. If 88% of healthy participants have positional nystagmus then how is the clinician to interpret the presence of positional nystagmus in a patient presenting with dizziness and/or disequilibrium? The primary purpose of this investigation was to examine the prevalence and characteristics of positional nystagmus in patients evaluated specifically for dizziness and imbalance. Data was collected using retrospective chart review. 200 charts were randomly selected from all patients seen for evaluation of dizziness and imbalance over a period of eight months. Clinicians independently reviewed the data from positional testing for each chart. Nystagmus was present if there was a clear slow and fast phase component and there were three beats in a 10 s time window. Nystagmus direction and intensity data were collected. Results indicate positional nystagmus is present in 10.5% to 21% of patients evaluated for dizziness and imbalance. Use of liberal criteria for determining presence of positional nystagmus (i.e., 3 beats in 20 sec) may account for higher prevalence rates across other studies.