Case 12 · clinician
Oscillopsia and unsteadiness after months of IV gentamicin
Vignette
A 64-year-old man with a history of methicillin-resistant Staphylococcus aureus endocarditis received six weeks of intravenous gentamicin. He now reports oscillopsia while walking and inability to see signs while in a moving car. Examination: positive bilateral horizontal head impulse tests with corrective saccades. No nystagmus. Bucket SVV is 0.0° with a normal SD. Dynamic visual acuity drops by 5 lines with head motion. Caloric responses are bilaterally absent.
SVV trace
Symmetrically absent — and so the SVV is normal