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August 1968

Periodic Alternating Nystagmus

Author Affiliations

From the Temple University Medical Center, Philadelphia.

Arch Otolaryngol. 1968;88(2):148-151. doi:10.1001/archotol.1968.00770010150006

PERIODIC alternating nystagmus (PAN) is a jerky nystagmus, present on straight forward gaze but periodically shifting direction from left to right and vice versa. The duration of each period is of two to five minutes but fairly constant in each case. The amplitude, frequency, and speed of the nystagmus are influenced by fatigue, emotion, sleep, and alertness.

PAN has been described very few times in the literature since first reported in 1921. The purpose of this paper is to report a case which only could be demonstrated by means of electronystagmography, since it was not present when the eyes of the patient were open.

Report of a Case  A 71-year-old man was seen in the Vertigo Clinic of Temple University Medical School with a chief complaint of poor balance mostly upon rapid changes of body posture. He had a long history of tinnitus, progressive loss of hearing, hypertension, and glaucoma.