The 47 Types & 38 Causes of Nystagmus; (It’s Not Just Caused by Alcohol)

Field sobriety test

The horizontal gaze nystagmus test is an eye test approved by the National Highway Traffic Safety Administration(hereinafter NHTSA) as a tool to detect clues of impairment in drivers. The HGNtest is one of three psychomotor tests approved as part of the standardized field sobriety testing protocol employed by law enforcement officers throughout the United States and used here in Ohio. The HGN is a test of your eyes wherein the testing officer is looking for abnormal movements call saccades.  These movements make the eye appear to bounce or wobble.  The officer uses this movement to make a correlation to alcohol use.  This would valid only if we are able to demonstrate that nystagmus is specific to alcohol impairment.  However, we know that there are other causes of nystagmus.  It is up to your DUI lawyer to demonstrate another valid reason for what the officer is observing.  You can find information about the Horizontal Gaze Nystagmus test and its biases on this site.

Listed beloware some other scientifically recognized causes of nystagmus.

47 Types of Nystagmus

1. Acquired

2. Anticipatory(Induced)

3. Arthrokinetic(Induced,Somatosensory)

4. Associated(Induced,Stransky’s

5. AudioKinetic(Induced)

6. Bartel’s(Induced)

7. Brun’s

8. Centripetal

9. Cervical(NeckTorsion,Vestibular-0basilarArteryInsufficiency

10.Crcular/Elliptic/Oblique (Alternataing Windmill, Circumduction, Diagonal,

Elliptic, Gyratory, Oblique, Radiary)

11.Congenital (Fixation, Hereditary)


13.Convergence Invocked

14.Disaccociated, Disjunctive


16.Drug Induced (Barbiturate, Bow Tie, Induced)

17.Epileptic (Ictal

18.Flash Induced

19.Gaze-Evoked (Deviational, Gaze-Paretic, Neurasthenic, Seducible, Setting-In)


21.Induced (Provoked)

22.Intermittent Vertical


24.Latent/Manifest Latent (Monocular Fixation, Unimacular)

25.Lateral Medullary


27.Miner’s (Occupational)

28.Muscle Paretic (Myasthenic)

29.Optokinetic (Induced, Optomotor, Panoramic, Railway, Sigma)

30.Optokinetic After-Induced (Post-Optokinetic, Reverse Post-Optokinetic)

31.Pendular (Talantropia)

32.Periodic/Aperiodic Alternating

33.Physiologic (End-Point, Fatigue)

34.Pursuit After Induced

35.Pursuit Defect

36.Pseudo Spontaneous


38.Reflex (Baer’s)




42.Stepping Around





47.Vestibular (Agotropic, Geotro-Pic, Bechterew’s, Caloric, Compensatory,Electrical/Faradic/Gal Vanic, Labyrinthine, Pneumatic/Compression, Positional/Alcohol, Pseudo Caloric)

Obtained from Dr. L. F. Dell’Osso, Nystagmus, Saccadic Intrusions/Oscillations and Oscillopsia, 3 Current Neuro-Opthamology 147 (1989).  There are also 38 verified causes for a horizontal gaze nystagmus other than alcohol impairment.


38 Causes of Horizontal Gaze Nystagmus

1. ProblemsWithTheInnerEarLabyrinth

2. Irrigating The Ears With Warm Or Cold Water Under Peculiar Weather


3. Influenza

4. StreptococcusInfection

5. Vertigo

6. Measles

7. Syphilis

8. Arteriosclerosis

9. MuscularDystrophy

10.Multiple Sclerosis

11.Korchaff’s Syndrome

12.Brain Hemorrhage



15.Motion Sickness



18.Eye Muscle Fatigue


20.Changes In Atmospheric Pressure

21.Consumption Of Excessive Amounts Of Caffeine

22.Excessive Exposure To Nicotine


24.Circadian Rhythms

25.Acute Trauma To The Head

26.Chronic Trauma To The Head

27.Some Prescription Drugs, Tranquilizers, Pain Medications, Anti-Convulsants


29.Disorders Of The Vestibular Apparatus And Brain Stem

30.Cerebellum Dysfunction




34.Exposure To Solvents, PCB’s, Dry-Cleaning Fumes, Carbon Monoxide

35.Extreme Chilling


37.Continuous Movement Of The Visual Field Past The Eyes

38.Antihistamine Use

See Shultz v. State, 664 A.2d 60, 77 (Md. App. 1995) citing State v. Witte; State v. Clark, State v. Superior Court, and Mark A. Rouleau, Unreliability of the Horizontal Gaze Nystagmus Test, 4 Am.Jur. Proof of Facts 3d 439 (1989); Louise J. Gordy & Roscoe N. Gray, 3A Attorney’s Textbook of Medicine § § 84.63 and 84.64 (1990).

DUI attorney Charles M. Rowland II dedicates his practice to defending the accused drunk driver in FairbornDaytonSpringfieldKetteringVandaliaXeniaMiamisburgSpringboroHuber HeightsOakwoodBeavercreekCenterville and throughout Ohio.  He has the credentials and the experience to win your case and has made himself the Miami Valley’s choice for DUI defense.  Contact Charles Rowland by phone at 937-318-1DUI (937-318-1384), 937-879-9542, or toll-free at 1-888-ROWLAND (888-769-5263).  For after-hours help contact our 24/7 DUI HOTLINE at 937-776-2671.  For information about Dayton DUI sent directly to your mobile device, text DaytonDUI (one word) to 50500.  Follow DaytonDUI on Twitter @DaytonDUI or Get Twitter updates via SMS by texting DaytonDUI to 40404. DaytonDUI is also available on Facebook and on the DaytonDUI channel on YouTube.  You can also email Charles Rowland at: or write to us at 2190 Gateway Dr., Fairborn, Ohio 45324. “All I do is DUI.”

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