Balance test results - does anyone know what these test results mean?

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AJLang

AJLang

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Type 1
Had balance tests done today with electrodes stuck on me etc. Good news is that the “possible menieres” that was diagnosed three years ago has been ruled out.
BUT he said that the eye tests show something that is almost certainly neurological. I wondered if anyone knows what the following means. They were from ECOG and VNG tests. there was also a caloric test which was completely normal.
Gaze without fixation produced square waves
smooth pursuit was below normative data with cogwheeling
Random saccades produced under shoot
 
Well, if you want the bald meanings, I don’t know about square waves.

Cogwheeling in neurological terms refers to the jerkiness you get in intentional muscular movements in Parkinson’s disease. I don’t know if that is different in Ophthalmology, but I suspect not.

Saccades is a rapid movement of the eyes between fixation points.

Does that help? Probably not, for you at least, but it probably reads like a schoolbook to an Ophthalmologist. I doubt we have one on the forum. So best to see what they say, probably.

Hope they do get the root of the problem soon.

All the best
 
Thanks Mike. That's a really helpful explanation. You've prompted my memory that about eight years ago Moorfields Orthoptics said that my right eye jerks! I'd forgotten about that. I never did find out what causes it but they didn't seem too bothered so hopefully this will be ok this time. The Head of Audiology has asked me to discuss the test results at my neurology appointment that I have next week.
 
Glad to be of help. If the eye was jerking 8 years ago, that for sure eliminates Parkinson’s as a cause. Mind you, neurologists can take an awful long time coming to definite conclusions, at least in my experience!
 
Thank you for the reassurance MIke. I am a bit concerned that my neurologist seems fixated that all of my issues are because of silence migraines due to the brain MRIs being clear.
 
My meniers turned out to be vestibular migraine now controlled with amitryptaline
 
jeanettem1 said:
My meniers turned out to be vestibular migraine now controlled with amitryptaline
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Thank you Jeanette for letting me know. I'm really glad that the amitriptylene worked for you. Vestibular migraine has been ruled out because the tests showed that my vestibular system is absolutely fine.
 
I'll second mikeyB's comment about the time taken by neurologists to come to conclusions.

I've been seeing one since, amongst other things, my eyes started jumping around about 10 years ago and I still do not have a diagnosis, despite his concern about the movement. I think it is because the diagnostic tools they have are pretty crude and they rely more than most physicians on patient observation and relating that to their experience.

If your MRI scans are clear (as mine have been) then my experiences suggest the chances are you are going to be on a long journey with this one. And you can look forward to more latinesque words, acronyms and technical results which when translated mean something like, "not sure what is going on but I don't think it is sinister".
 
Docb said:
I'll second mikeyB's comment about the time taken by neurologists to come to conclusions.

I've been seeing one since, amongst other things, my eyes started jumping around about 10 years ago and I still do not have a diagnosis, despite his concern about the movement. I think it is because the diagnostic tools they have are pretty crude and they rely more than most physicians on patient observation and relating that to their experience.

If your MRI scans are clear (as mine have been) then my experiences suggest the chances are you are going to be on a long journey with this one. And you can look forward to more latinesque words, acronyms and technical results which when translated mean something like, "not sure what is going on but I don't think it is sinister".
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Thank you DocB. You have made me feel better in a way that’s it not just me wading through whatever this is with no clear answers.
 
Is it still one eye, or both?
The "square wave" is referring to the movement that takes the eye (or eyes) of target, the brings them back to the original point.
So it's going from one point to another, then after a period returning to the original point.
An abrupt change, not a slow one, hence the "square wave"
"Cogwheeling" is a jerky movement noticeable as you move you eye intentionally, rather than a smooth movement from point to point.
"Random saccades produced under shoot" means you look at a point, your eye don't quite get there, and you need to make a second correction movement to achieve the target.

As to the cause, as said, if it's already been eight years, it's probably won't be a fast answer I'm afraid.
Has it got worse in those years?
 
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Thank you @travellor In 2014 the Moorfields orthoptics consultant only saw jerks in the right eye. These latest tests have shown it in both eyes and it seems to be constant now. Before I went for the balance test I asked Mark to do the pencil test whilst watching my eyes. He did this over different days and could see both eyes jerking/jumping.
The reading problems with regard to mis-reading words etc has been about 3-4 years and the balance/dizziness issues etc etc have been about four years. I also find it a lot more difficult now to concentrate on reading in recent years, even though it’s always large print and I have my eyes regularly checked.
 
It sounds like you are being looked after anyway, and getting the right care.
But it doesn't appear they have an answer from the tests so far, so keep after them, push for more consultations, and I hope you get the result you want soon.
 
AJLang said:
Thank you @travellor In 2014 the Moorfields orthoptics consultant only saw jerks in the right eye. These latest tests have shown it in both eyes and it seems to be constant now. Before I went for the balance test I asked Mark to do the pencil test whilst watching my eyes. He did this over different days and could see both eyes jerking/jumping.
The reading problems with regard to mis-reading words etc has been about 3-4 years and the balance/dizziness issues etc etc have been about four years.
Click to expand...
travellor said:
It sounds like you are being looked after anyway, and getting the right care.
But it doesn't appear they have an answer from the tests so far, so keep after them, push for more consultations, and I hope you get the result you want soon.
Click to expand...
Thank you @travellor the only consultant I’m seeing about this now is the neurologist. He has said that if the MRI is clear then he will assume that it is migraines and that’s it although he did admit for the first time that I don’t meet the normal Pattern for migraines. It’s very frustrating but I’m trying to stay positive.
 
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