Periodic alternating nystagmus and perverted head-shaking nystagmus in cerebellar degeneration

Update item information
Identifier PAN_and_hsDBN_01
Title Periodic alternating nystagmus and perverted head-shaking nystagmus in cerebellar degeneration
Subject Headshaking, Cerebellar, Jerk Nystagmus, Periodic Alternating Nystagmus
Creator Daniel R. Gold, DO, Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, The Johns Hopkins School of Medicine
Description This is a 60-yo-woman with several years of worsening imbalance, diplopia (hers was actually unrelated to cerebellar pathology [although she did have an esotropia greater at distance that was cerebellar in origin] and due to thyroid eye disease) and blurry vision (due to her spontaneous nystagmus). There was also corectopia OD and she was status post cataract surgery in this eye. Examination demonstrated alternating right-beating and left-beating nystagmus every 90 or so seconds (with a null period in between) consistent with periodic alternating nystagmus (PAN). PAN localizes to the nodulus and uvula, and is occasionally seen with cerebellar degenerations (SCA 6 among others). Baclofen can be helpful for PAN, and therapy was initiated in this particular patient. She also had hypermetric saccades, choppy smooth pursuit and VOR suppression, gaze-evoked nystagmus, as well as perverted nystagmus with head-shaking - i.e., with horizontal head-shaking, vertical nystagmus (downbeating) was apparent). This is another central vestibular/ocular motor sign, and can also be seen with nodulus/uvula pathology - this finding can be seen at the end of the video.
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2017
Type Image/MovingImage
Format video/mp4
Rights Management Copyright 2017. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E, SLC, UT 84112-5890
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Language eng
ARK ark:/87278/s62k013r
Setname ehsl_novel_gold
Date Created 2017-02-23
Date Modified 2017-06-21
ID 1209729
Reference URL https://collections.lib.utah.edu/ark:/87278/s62k013r
Back to Search Results