Unidirectional nystagmus in lateral medullary syndrome

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Identifier Unidirectional Nystagmus Lateral Medullary
Title Unidirectional nystagmus in lateral medullary syndrome
Subject Medula, Rotary Nystagmus, Jerk Nystagmus, Acute Vestibula, Vestibular Nystagmus, Abnormal Saccades
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-yo-man who presented with acute vertigo. Examination demonstrated very mild spontaneous torsional nystagmus (towards the right ear) in primary (not seen well in this video), with robust downbeat-torsional (towards right ear) nystagmus in right gaze and (less robust) almost pure torsional nystagmus (still beating towards right ear) in left gaze. This video makes the a small unilateral posterior fossa lesion can cause unidirectional nystagmus even in accordance with Alexander's law that might make the clinician suspect a peripheral lesion. Arguing strongly in his case for a central localization were: 1) the vertical-torsional nystagmus (acute peripheral nystagmus is generally horizontal-torsional), and 2) his saccadic dysmetria (hyper to right and hypo to left). The saccadic dysmetria, in this case, does have localizing value as hypermetric saccades are always ipsilesional in Wallenberg syndrome. The nystagmus seen in Wallenberg is usually contralesional, but can also be ipsilesional as in this case.
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2016
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/s6h4514n
Setname ehsl_novel_gold
Date Created 2016-10-27
Date Modified 2019-11-20
ID 187760
Reference URL https://collections.lib.utah.edu/ark:/87278/s6h4514n
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