Downbeat nystagmus increasing in lateral and downgaze
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
Subject
Downbeat nystagmus; Gaze evoked nystagmus
Description
This is a patient with cerebellar ataxia presenting with vertical oscillopsia (from downbeat nystagmus, DBN) and progressive imbalance. Gaze-evoked nystagmus is also present, giving a "side pocket" nystagmus trajectory in lateral gaze. DBN is maximal in lateral and downgaze, making progressives, bifocals and trifocals a challenge for these patients - e.g., when looking down through the reading portion of their spectacles, DBN and oscillopsia increase, making it harder to read.
