Breastfeeding Nystagmus Secondary to Tullio's Phenomenon

Inner ear pathology is well documented associated with Down's Syndrome (DS), including absence or dehiscence of the semicircular canals. Up to 30% of children with DS demonstrate nystagmus. Tullio's phenomenon is typified by vertigo, nystagmus, or oscillopsia induced by sound or middle ear pressure (e.g. applied pressure to the tragus). We examined an 8- month-old with DS and infantile nystagmus produced in a single position while breastfeeding. Temporal bone scanning revealed complete opacification of the mastoid and middle ear, associated with thinning of the semicircular canals.