Hyperventilation-induced (exercise-induced) nystagmus is an uncommon condition most often associated with a disorder of the vestibular nerve.

Clinical features:

(1) presence of nystagmus after the person hyperventilates or exercises

(2) absence of nystagmus while at rest

(3) The patient may complain of vertigo or disequilibrium.

(4) A patient with vestibular nerve dysfunction may have reduced hearing.


The onset may be associated with a sufficiently elevated end-tidal CO2 (Et CO2).


Causes of HIN:

(1) vestibular nerve dysfunction (vestibular schwannoma, vestibular neuritis, vascular compression, other)

(2) tremor

(3) multiple sclerosis

(4) cerebellar dysfunction

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