Idiopathic downbeat nystagmus exacerbated with positional maneuvers - Part 2: patient is now on 4-aminopyridine

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Identifier DBN_positional_4AP_mute
Title Idiopathic downbeat nystagmus exacerbated with positional maneuvers - Part 2: patient is now on 4-aminopyridine
Subject Downbeat nystagmus, Jerk nystagmus, Central positional 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 45-yo-woman presented in "Idiopathic downbeat nystagmus exacerbated with positional maneuvers". This video was taken after the patient had been on 4-aminopyridine for 3 months. There was marked improvement in subjective oscillopsia and objective downbeat nystagmus. The strong positional component coupled with the pure DBN in right and left gaze and alternating skew deviation, suggests that an otolithic imbalance (as opposed to semicircular canal imbalance) is responsible for her DBN. Saccades, smooth pursuit, VOR suppression, VOR and head impulse testing and tests of appendicular ataxia were all normal, arguing against a flocculus/paraflocculus localization. A lesion involving the nodulus seemed much more likely and SCA 6 testing is pending.
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Type Image/MovingImage
Format video/mp4
Rights Management Copyright 2016. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Language eng
ARK ark:/87278/s6sn3jng
Setname ehsl_novel_gold
Date Created 2016-10-11
Date Modified 2017-05-15
ID 187750
Reference URL https://collections.lib.utah.edu/ark:/87278/s6sn3jng
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