Periodic Alternating Nystagmus Due to Nodulus Stroke - Figure 1

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Identifier PAN_from_stroke_figure
Title Periodic Alternating Nystagmus Due to Nodulus Stroke - Figure 1
Subject Periodic Alternating Nystagmus; Jerk 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 70-year-old woman who experienced the acute onset of vertigo and imbalance. MRI demonstrated a diffusion-weighted imaging hyperintensity involving the nodulus (with corresponding ADC hypointensity) consistent with an acute stroke. On examination several weeks after the stroke, periodic alternating nystagmus (PAN) was apparent - e.g., there was spontaneous right-beating nystagmus for ~90 seconds which slowed down and then stopped (null period), and then reversed direction to left-beating nystagmus for ~90 seconds, and so on. Because the nodulus normally mediates the velocity storage mechanism (which prolongs and amplifies peripheral vestibular inputs), disinhibition of velocity storage may result in PAN. Baclofen is usually the most effective therapy for PAN. [[Number of Figures and legend for each: 1, Hyperintensity of the nodulus on MR diffusion-weighted imaging suggestive of acute stroke; Number of Videos and legend for each: 1, Patient with periodic alternating nystagmus following a nodulus stroke.]] See case video, CLICK HERE:
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2017-12
Type Image
Format image/jpeg
Relation is Part of NOVEL: Neuro-ophthalmology Virtual Education Library Examination Collection
Rights Management Copyright 2017. For further information regarding the rights to this collection, please visit:
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
Language eng
ARK ark:/87278/s6963fd8
Setname ehsl_novel_gold
Date Created 2017-12-04
Date Modified 2021-05-06
ID 1284821
Reference URL
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