I am a 21 year old female. I suffer from very rapid up-beating and sometimes down-beating nystagmus, which exclusively occurs in the absence of visual stimulation. That is with my eyes closed and Frenzel goggles on. When the nystagmus occurs quite intensely, my eyes will bounce under my eyelids and cause quite a nuisance. My neuro-otologist provided me with goggles to record my own eyes. From the recordings, I notice my pupil constrict significantly when they nystagmus occurs intensely despite being in total darkness. Why do my pupils constrict when the nystagmus occurs despite being in total darkness? When the nystagmus stops, my pupils dilate back to the normal size.
I was diagnosed with a vestibular migraine. My symptom includes vertigo, dizziness, headaches, balance issues, binaural tinnitus, and cognitive issues. I have undergone routine vestibular testing. My rotational chair and caloric test results came back hyper-responsive. VEMP testing came back normal. And my brain MRI came back unremarkable. I have been on Amitriptyline 25 mg, and I am currently on Pizotifen 0.5 mg.
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Thank you so much for your response. It was really helpful. As a final to this, does constriction of the pupil occur in patients who have nystagmus that is not caused by vestibular migraines? Or is constriction of the pupil something that only occurs for patients who have nystagmus caused by vestibular migraines? And I have also noticed that my nystagmus does not necessarily get worse when I am experiencing heightened vertigo and dizziness. At times when I have had the worst nystagmus, I did not necessarily feel excessively dizzy or vertigo. Is that a reason for this? Thanks.
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