Downbeat nystagmus and cerebellar atrophy

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Identifier Downbeat_nystagmus_and_cerebellar_atrophy
Title Downbeat nystagmus and cerebellar atrophy
Subject Downbeat Nystagmus, OMS Cerebellar, Jerk Nystagmus, Vestibular 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 40-year-old man with 2 years of progressive ataxia and oscillopsia. On examination, he had downbeat nystagmus (DBN), an ocular motor finding that is usually (but not always) associated with flocculus/paraflocculus dysfunction, which causes overaction of the anterior canal (upward or anti-gravity) pathways relative to posterior canal (downward or gravity) pathways. This results in a continuous slow upward phase and subsequent fast downward phase, causing the DBN. In his case, there was a history of a testicular seminoma (s/p resection) several years prior to presentation, and during the initial work-up he was found to have a CSF lymphocytic pleocytosis, but had unrevealing paraneoplastic panels (serum and cerebrospinal fluid), brain MRI and body PET/CT-these exams were repeated several times over 1-2 years. There was no clear response to steroids and IVIG, and for his DBN, trials of 4-aminopyridine and chlorzoxazone were ineffective. After 2 years, significant cerebellar atrophy was apparent on his MRI.
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2018-04
Format video/mp4
Rights Management Copyright 2018. For further information regarding the rights to this collection, please visit:
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Language eng
ARK ark:/87278/s65181nc
Setname ehsl_novel_gold
Date Created 2018-04-26
Date Modified 2018-05-23
ID 1316077
Reference URL
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