CLINICAL EXAMINATION OF EQUILIBRIUM

1. Examination for Nystagmus (Abnormal Oscillatory eye movements):

• Direct Observation: By the naked eyes or Frenzel’s Glasses, which are illuminated magnifying lenses. They are worn by the patient to magnify his eyes and abolish visual fixation that can inhibit nystagmus.

Figure 20: Frenzel’s Glasses.

• Electronystagmography: Detection of nystagmus on a graph.

2. Caloric test: each external ear is washed by sterile water 7º C above and below body temperature i.e. 44 & 30º C, each time is for 40 seconds. The type and duration of the resulting nystagmus is noticed:

• Normally, it lasts for 2 minutes.

• In vestibular hypofunction, it lasts less than 2 minutes.

• In dead ear, it does not occur.

Examination for Ataxia (loss of postural equilibrium)

• Romberg’s Test: the patient stands with his feet close together and his arms in front of his chest, his eyes are open ≫ then closed. In Vestibular disease ≫ the patient is more unsteady when the eyes are closed.

Category: ENT Notes