Nystagmus in Pregnant Patients with Headache

Introduction to Nystagmus and Headache

• The American Academy of Otolaryngology-Head and Neck Surgery suggests that nystagmus in a pregnant patient with headache may indicate structural neurologic pathology affecting the brainstem, cerebellum, or vestibular system 1

Increased Intracranial Pressure and Vascular Events

• The Journal of Neurology, Neurosurgery and Psychiatry recommends considering increased intracranial pressure from conditions like idiopathic intracranial hypertension or eclampsia in pregnant patients with nystagmus and headache 2

Preeclampsia/Eclampsia Diagnosis and Management

• According to Praxis Medical Insights, a new headache in a pregnant woman with hypertension should be considered part of preeclampsia until proven otherwise, and requires urgent blood pressure assessment and evaluation for end-organ damage 3

Differential Diagnosis and Diagnostic Approach

• The American Academy of Otolaryngology-Head and Neck Surgery indicates that the presence of nystagmus makes benign positional vertigo (BPPV) unlikely, as BPPV has specific positional triggers and characteristic nystagmus patterns not typically associated with persistent headache 1
• The Journal of Neurology, Neurosurgery and Psychiatry suggests that papilledema may be a sign of increased intracranial pressure in pregnant patients with nystagmus and headache 2