A year-old woman presented with gradual-onset left-sided hearing loss, progressive diminution of vision, headache and unsteadiness of gait. Comprehensive clinical evaluation revealed a left-sided lower motor neuron type of facial nerve palsy figure 1 , bilateral papilloedema, sensory loss in the distribution of ophthalmic branch of the left trigeminal nerve and cerebellar ataxia. Sensorineural hearing loss and absent corneal reflex were also observed on the left side. A coarse, left-beating nystagmus with leftward gaze and a fine primary-position right-beating nystagmus which increased on rightward gaze, consistent with Bruns nystagmus video 1 , were appreciated.
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A year-old woman presented with insidious onset of hearing loss on the left side along with progressive unsteadiness of gait and diminution of vision. She had features of increased intracranial pressure. Clinical examination revealed gross papilledema in both eyes with secondary optic atrophy. A right-sided lower motor neuron type of facial palsy was present.
Corneal reflex was absent on the right side. Eye movements were full. A coarse right-beating nystagmus with rightward gaze and a fine primary-position left-beating nystagmus which was appreciated by ophthalmoscopy that increased on leftward gaze, consistent with Bruns nystagmus, was noticed video. Hence, a space-occupying lesion in the right cerebellopontine angle was considered.
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Bruns Nystagmus and Contrast-Enhanced Computed Tomography of the Brain
The movement can be horizontal, vertical, torsional or a combination of these movements. Nystagmus can be jerk named for fast phase or pendular, variable amplitude and frequency, and can be worsened or improved by gaze position, fixation, or covering one eye latent. This is in contrast to "saccadic intrusions" or "saccadic oscillations", which are defined as "fast, back to back without intersaccadic interval " eye movements driving the eye off the visual target. In this article, different types of nystagmus, their etiologies, and treatment modalities are discussed. It has been reported to be as low as 6.
Bruns nystagmus: an important clinical clue for cerebellopontine angle tumours
Bruns Nystagmus in Cerebellopontine Angle Tumor