👀 Subtle spontaneous nystagmus? The head-shaking test is an essential clinical tool. This patient presented with mild vestibular symptoms, and spontaneous nystagmus was barely visible on initial inspection. After performing the head-shaking test (20 cycles at approximately 2 Hz), we were able to accentuate the underlying nystagmus, making it significantly easier to identify the pattern and laterality. 🔍 Why does this work? Head shaking fatigues the velocity storage mechanism and unmasks asymme
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😳 Do you use the (horizontal) head shake test, also known as head shaking nystagmus? 🧰 How to perform: 1. Patient is seated. 2. With the head tilted 30° forward, the clinician oscillates the patient’s head side-to-side (2 Hz speed) for about 20 seconds while fixation is removed by infrared video goggles. 3. Stop moving the head and ensure that the patient’s eyes are open to observe any nystagmus. ✅ A normal finding is 3 beats of horizontal nystagmus or less (often no nystagmus is present). ❌ A
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