Isolated Horner Syndrome From an Elongated Styloid Process (Eagle Syndrome)

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Title Isolated Horner Syndrome From an Elongated Styloid Process (Eagle Syndrome)
Creator Chang, Caitlin A; Lin, Tony; Fung, Kevin; Sharma, Manas; Fraser, J Alexander
Affiliation Department of Neurology, Eginition Hospital, University of Athens, Athens, Greece
Subject Aged; Carotid Artery, Internal; Female; Horner Syndrome; Humans; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Manipulation, Chiropractic; Ossification, Heterotopic; Temporal Bone
Abstract Cerebellar ataxia is an uncommon manifestation of hypothyroidism with unknown pathomechanism. The few descriptions of the clinical phenotype range from limb, gait, and trunk ataxia to various ocular motor abnormalities. We evaluated a 62-year-old woman with previously undetected severe hypothyroidism who presented with prominent saccadic intrusions and gait ataxia. She had high titers of antithyroid autoantibodies and anti-glutamic acid decarboxylase (anti-GAD) antibodies. Horizontal eye movement recordings revealed a series of nearly continuous pseudoharmonic square wave jerks (SWJs) constituting a square wave oscillation. Amplitudes reached maximum values of about 4, and wave frequency approached 100 cycles per minute. Thyroxine substitution and corticosteroid administration had little effect on SWJ parameters. The square wave oscillation nearly completely resolved after a single treatment session with intravenous immunoglobulin suggesting a causal link between an autoimmune process and the cerebellar dysfunction. Current concepts of the genesis of saccadic intrusions favor a role for anti-GAD antibodies in the etiology of SWJs.
OCR Text Show
Publisher Lippincott, Williams & Wilkins
Date 2015-12
Type Text
Language eng
Rights Management © North American Neuro-Ophthalmology Society
Publication Type Journal Article
ARK ark:/87278/s65x64dp
Setname ehsl_novel_jno
Date Created 2017-09-14
Date Modified 2017-09-14
ID 1276428
Reference URL https://collections.lib.utah.edu/ark:/87278/s65x64dp
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