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Here we evaluate GEN in patients with AVS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective cross\u2010sectional study, we used video\u2010oculography (VOG) to compare GEN in the light (target at 15\u00b0 eccentric) in 64 healthy subjects with 47 patients seen in the emergency department (ED) who had AVS; 35 with vestibular neuritis and 12 with stroke. All patients with an initial non\u2010diagnostic MRI received a confirmatory, delayed MRI as a reference standard in detecting stroke.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Healthy subjects with GEN had a time constant of centripetal drift &gt;18\u00a0s. VOG identified pathologic GEN (time constant\u00a0\u2264\u00a018\u00a0s) in 33% of patients with vestibular strokes, specificity was 100%, accuracy was 83%. Results were equivalent to examination by a clinical expert. As expected, since all patients with GEN had a SN in straight\u2010ahead position, they showed the pattern of a Bruns\u2019 nystagmus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>One third of patients with AVS due to central vestibular strokes had a spontaneous SN in straight\u2010ahead gaze and a pathological GEN, producing the pattern of a Bruns\u2019 nystagmus with a shift of the null position. The localization of the side of the lesion based on the null was not consistent, presumably because the circuits underlying gaze\u2010holding are widespread in the brainstem and cerebellum. Nevertheless, automated quantification of GEN with VOG was specific, and accurately identified patients in the ED with AVS due to strokes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.14997","type":"journal-article","created":{"date-parts":[[2021,6,27]],"date-time":"2021-06-27T19:04:12Z","timestamp":1624820652000},"page":"2971-2979","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Bruns' nystagmus revisited: A sign of stroke in patients with the acute vestibular syndrome"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2268-7811","authenticated-orcid":false,"given":"Georgios","family":"Mantokoudis","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Inselspital, Bern University Hospital University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasia","family":"Korda","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Inselspital, Bern University Hospital University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Zee","sequence":"additional","affiliation":[{"name":"Department of Neurology Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"Zamaro","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Inselspital, Bern University Hospital University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas C.","family":"Sauter","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Inselspital, Bern University Hospital University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7502-4814","authenticated-orcid":false,"given":"Franca","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Inselspital, Bern University Hospital University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco D.","family":"Caversaccio","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Inselspital, Bern University Hospital University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/med\/9780199969289.001.0001"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012176"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12311-015-0688-2"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.551234"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3233\/VES-190658"},{"key":"e_1_2_11_7_1","first-page":"84","volume-title":"Handbuch der Kinderheilkunde","author":"Alexander G","year":"1912"},{"key":"e_1_2_11_8_1","unstructured":"BrunsL.Die Geschw\u00fclste des Nervensystems: Hirngeschw\u00fclste R\u00fcckenmarks\u2010 und Wirbelgeschw\u00fclste. 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