Video 4.41 Downbeat and gaze-evoked nystagmus, impaired smooth pursuit, and saccadic hypermetria in spinocerebellar ataxia type 8 from Neuro-Ophthalmology and Neuro-Otology Textbook
Creator
Daniel R. Gold, DO
Affiliation
(DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland
𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 30-yo-man with a diagnosis of SCA 8 who had appendicular and gait ataxia in addition to choppy smooth pursuit and VORS, downbeat nystagmus, saccadic hypermetria, and gaze-evoked nystagmus with rebound nystagmus. He also had an esotropia worse at distance, which is commonly found with cerebellar degenerations. Video shows a variety of cerebellar eye signs including downbeat nystagmus, saccadic dysmetria, gaze-evoked nystagmus (with rebound), and abnormal VOR suppression. 𝗡𝗲𝘂𝗿𝗼-𝗼𝗽𝗵𝘁𝗵𝗮𝗹𝗺𝗼𝗹𝗼𝗴𝘆 𝗮𝗻𝗱 𝗡𝗲𝘂𝗿𝗼-𝗼𝘁𝗼𝗹𝗼𝗴𝘆 𝗧𝗲𝘅𝘁𝗯𝗼𝗼𝗸 𝗟𝗲𝗴𝗲𝗻𝗱: This patient also had a symptomatic esotropia at distance consistent with divergence insufficiency, which is a common cause of strabismus (due to involvement of ocular motor vermis and/or flocculus) in cerebellar degenerations. https:// collections.lib.utah.edu/ark:/87278/s6dj8q9h
