Which statement about nystagmus caused by a labyrinthine lesion is most accurate?

Which statement about nystagmus caused by a labyrinthine lesion is most accurate?

• A. It is pendular when the eyes are closed.
• B. It is enhanced with eyes open.
• C. It is up-beating on up gaze and down-beating on down gaze.
• D. It is suppressed by visual fixation.

Answer: (D)

Peripheral vestibular nystagmus from a labyrinthine lesion is typically suppressed by visual fixation. When a person fixates on a target with their eyes open, the brain uses vision to help stabilize gaze and dampens the reflexive eye movements caused by the unilateral vestibular deficit. Remove fixation—such as with eyes closed or in darkness—and the nystagmus usually becomes more noticeable. This suppression by fixation is a hallmark that helps distinguish peripheral labyrinthine nystagmus from central types, which can be vertical (upbeat or downbeat) or not reliably reduced by fixation. So the accurate statement is that the nystagmus is suppressed by visual fixation.

Peripheral vestibular nystagmus from a labyrinthine lesion is typically suppressed by visual fixation. When a person fixates on a target with their eyes open, the brain uses vision to help stabilize gaze and dampens the reflexive eye movements caused by the unilateral vestibular deficit. Remove fixation—such as with eyes closed or in darkness—and the nystagmus usually becomes more noticeable. This suppression by fixation is a hallmark that helps distinguish peripheral labyrinthine nystagmus from central types, which can be vertical (upbeat or downbeat) or not reliably reduced by fixation. So the accurate statement is that the nystagmus is suppressed by visual fixation.