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Hyperventilation Induced Nystagmus in Patient with Vestibular Schwannoma : A Case Report
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Yoon Jeong Chang, Geun Ho Lee, Chang Min Lee, Young Mok Song, Chung Ku Rhee, Jae Il Kim
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J Korean Bal Soc. 2004;3(1):177-179.
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 Abstract
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- When doctors evaluate the complaints of dizziness, they often perform a series of clinical tests to look for the
evidence of a vestibular dysfunction. A useful procedure is to ask the patient to take deep breaths and observe the gaze
behind Frenzel goggles. If hyperventilation-induced nystagmus(HIN) is detected, it is the evidence for an underlying
vestibular imbalance. The authors evaluated nystagmus with electronystagmography after hyperventilation for 50
seconds. Brain imaging was performed to search the responsible lesion for dizziness. Brain MRI revealed a brain tumor
suggesting vestibular schwannoma in the left cerebellopontine angle. After hyperventilation, dizziness and the right
beating horizontal nystagmus with Alexander law could be detected. By precisely measuring the HIN, we determined
that inputs arising from the horizontal semicircular canal were mainly responsible. The contralaterality of the direction
of the horizontal component of the nystagmus was detected. We suggest that clinicians should routinely check the
nystagmus after hyperventilation, when they evaluate patients complaining of dizziness.
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KBS
