Nystagmus Due to Paraneoplastic (Anti-Yo) Brainstem and Cerebellar Degeneration

𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 40-yo-woman with anti-Yo antibody associated with ovarian cancer. Initial symptoms 2.5 years prior (to this video) included imbalance and dysarthria. She complained of oscillopsia which was due to her upbeat nystagmus (presumably the result of brainstem involvement), and diplopia (she had an esotropia greater at distance which is common with cerebellar pathology). There were also intermittent spontaneous saccadic intrusions, hypermetric saccades, choppy smooth pursuit and VOR suppression - ocular motor abnormalities that are commonly seen with posterior fossa disease. At the time when the video was taken (2.5 years after symptom onset), severe brainstem and cerebellar atrophy was apparent on MRI. 𝗡𝗲𝘂𝗿𝗼-𝗼𝗽𝗵𝘁𝗵𝗮𝗹𝗺𝗼𝗹𝗼𝗴𝘆 𝗮𝗻𝗱 𝗡𝗲𝘂𝗿𝗼-𝗼𝘁𝗼𝗹𝗼𝗴𝘆 𝗧𝗲𝘅𝘁𝗯𝗼𝗼𝗸 𝗟𝗲𝗴𝗲𝗻𝗱: This is a patient who was diagnosed with anti-Yo antibody-related cerebellar syndrome due to ovarian cancer 2 years prior to this video. She complained of oscillopsia due to spontaneous upbeat nystagmus (presumably the result of brainstem involvement), and on examination, she had intermittent saccadic intrusions, hypermetric saccades (in all planes), saccadic smooth pursuit and vestibulo-ocular reflex suppression. MRI demonstrated severe brainstem and cerebellar atrophy. https://collections.lib.utah.edu/ark:/87278/s6bz9v92