Bruns Nystagmus Due to a Cerebellopontine Angle Tumor
Alternative Title
Video 5.6 Bruns nystagmus due to a cerebellopontine angle vestibular schwannoma from Neuro-Ophthalmology and Neuro-Otology Textbook
Creator
Daniel R. Gold, DO; Veeral S. Shah, MD, PhD
Affiliation
(DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland; (VS) Departments of Ophthalmology, Pediatric and Adult Neuro-Ophthalmology, Texas Children's Hospital, Baylor College of Medicine, University of Texas, Austin, Texas
𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 15-yo-girl who experienced headache and imbalance leading to an MRI which showed a left sided cerebellopontine angle (CPA) tumor. Because of involvement of the left brainstem/cerebellum (e.g., dysfunction of the neural integrator/gaze holding apparatus) by the CPA mass, there was left-beating ipsilesional "gaze-evoked" nystagmus in left gaze. Note the larger amplitude and lower frequency gaze-evoked nystagmus in left gaze. Because of involvement of the left 8th cranial nerve, there was right-beating contralesional "vestibular" nystagmus in right gaze (in accordance with Alexander's law). Note the smaller amplitude and higher frequency vestibular nystagmus in right gaze. 𝗡𝗲𝘂𝗿𝗼-𝗼𝗽𝗵𝘁𝗵𝗮𝗹𝗺𝗼𝗹𝗼𝗴𝘆 𝗮𝗻𝗱 𝗡𝗲𝘂𝗿𝗼-𝗼𝘁𝗼𝗹𝗼𝗴𝘆 𝗧𝗲𝘅𝘁𝗯𝗼𝗼𝗸 𝗟𝗲𝗴𝗲𝗻𝗱: This patient experienced headache and imbalance leading to an MRI which showed a left sided cerebellopontine angle (CPA) vestibular schwannoma. Because of involvement of the left brainstem/cerebellum (e.g., dysfunction of the neural integrator/gaze holding apparatus) by the CPA mass, there was left-beating ipsilesional "gaze-evoked" nystagmus in left gaze. Note the larger amplitude and lower frequency gaze-evoked nystagmus in left gaze. Because of involvement of the left 8th cranial nerve, there was right-beating contralesional "vestibular" nystagmus in right gaze (in accordance with Alexander's law). Note the smaller amplitude and higher frequency vestibular nystagmus in right gaze. https://collections.lib.utah.edu/ark:/87278/s60p4p3j (Video courtesy of Dr. Veeral Shah)
