Differential Diagnosis for One-Sided Nystagmus in Kids
- Single Most Likely Diagnosis
- Benign Paroxysmal Vertigo of Childhood: This condition is a common cause of vertigo and nystagmus in children, often presenting with brief episodes of vertigo and nystagmus that can be unilateral.
- Other Likely Diagnoses
- Vestibular Neuritis: An inflammation of the vestibular nerve can cause nystagmus, vertigo, and balance problems, which may be unilateral.
- Labyrinthitis: Inflammation of the inner ear's labyrinth can lead to nystagmus, hearing loss, and vertigo, potentially presenting unilaterally.
- Congenital Nystagmus: Although typically bilateral, some forms of congenital nystagmus can present with unilateral features or be more pronounced on one side.
- Do Not Miss Diagnoses
- Brain Tumor (e.g., Cerebellar or Brainstem Tumors): Although rare, tumors in the brain can cause nystagmus due to increased intracranial pressure or direct involvement of the brainstem or cerebellum. Missing this diagnosis could be fatal.
- Stroke or Cerebral Vasculitis: Unilateral nystagmus could be a sign of a stroke or cerebral vasculitis in children, which requires immediate medical attention.
- Multiple Sclerosis: Although more common in adults, pediatric multiple sclerosis can present with a wide range of neurological symptoms, including unilateral nystagmus.
- Rare Diagnoses
- Chiari Malformation: A structural defect in the cerebellum that controls balance can cause nystagmus among other symptoms, and while rare, it's an important consideration.
- Superior Oblique Myokymia: A rare condition that affects the superior oblique muscle, leading to intermittent, unilateral nystagmus.
- Perilymph Fistula: An abnormal connection between the inner and middle ear can cause nystagmus, vertigo, and hearing loss, which might present unilaterally.