Chiari malformation causing downbeat nystagmus in lateral gaze

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Identifier Chiari_DBN_with_lateral_gaze
Title Chiari malformation causing downbeat nystagmus in lateral gaze
Subject Jerk Nystagmus, Gaze Evoked Nystagmus, Downbeat Nystagmus
Creator Daniel R. Gold, DO, Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine
Description This is a 20-yo-man who presented with oscillopsia in lateral gaze from downbeat nystagmus (DBN). In primary gaze, very subtle DBN was only noted with ophthalmoscopy, but in lateral gaze, prominent DBN was present. Other central ocular motor signs included gaze-evoked nystagmus (GEN) vertically, in addition to mild GEN in lateral gaze, with rebound nystagmus when returning from lateral to primary gaze (not shown in the video). The combination of DBN and GEN in right and left gaze can produce an oblique or diagonal nystagmus that beats down and out, also known as "side-pocket" nystagmus, which was present to a mild degree in this patient. Additionally, pursuit and VOR suppression were impaired (choppy) in all directions. MRI demonstrated that the cerebellar tonsils extended about 20 mm below the foramen magnum, consistent with a Chiari (type 1) malformation.
Contributor Daniel R. Gold, D.O.
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2017
Format video/mp4
Rights Management Copyright 2016. For further information regarding the rights to this collection, please visit:
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Language eng
ARK ark:/87278/s6934mzv
Setname ehsl_novel_gold
Date Created 2017-07-26
Date Modified 2018-01-22
ID 1256236
Reference URL
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