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Convergence Nystagmus Associated With Arnold-Chiari Malformation

Convergence Nystagmus Associated With Arnold-Chiari Malformation Abstract • A case of convergence nystagmus associated with an Arnold-Chiari type I malformation is presented. The nystagmus appeared in the absence of fixation, was provoked during Valsalva's maneuver and neck flexion and extension, and attenuated on deep inspiration. Sagittal magnetic resonance images showed that the diameter of the cerebral aqueduct increased with the neck in full flexion and in full extension. Surgical foramen magnum decompression considerably reduced the nystagmus and abolished the postural variation of aqueduct diameter. It is postulated that this nystagmus was due to a combination of mechanical distortion and abnormal transmission of cerebrospinal fluid pressure to the aqueductal region. References 1. Cogan DG. Convergence nystagmus . Arch Ophthalmol . 1959;62:295-299.Crossref 2. Segarra JM, Ojeman RJ. Convergence nystagmus . Neurology . 1961;11:883-893.Crossref 3. Nashold BS, Gills JP, Durham NL. Ocular signs from brain stimulation and lesions . Arch Ophthalmol . 1967;77:609-618.Crossref 4. Keane JR, Davis RL. Pretectal syndrome with metastatic malignant melanoma to the posterior commissure . Am J Ophthalmol . 1976;82:910-914. 5. Christoff N, Anderson PJ, Bender MB. Convergence and retractory nystagmus . Trans Am Neurol Assoc . 1960:29-32. 6. Smith JL, Zieperi L, Gay AJ, Cogan DG. Retractorious . Arch Ophthalmol . 1959;62:864-867.Crossref 7. Baloh RW, Spooner JW. Downbeat nystagmus: a type of central vestibular nystagmus . Neurology . 1981;31:304-310.Crossref 8. Halmagyi GM, Rudge P, Gresty MA, Sanders MD. Downbeating nystagmus: a review of 62 cases . Arch Neurol . 1983;40:777-784. 9. Bronstein AM, Miller DH, Rudge P, Kendall BE. Downbeating nystagmus: magnetic resonance imaging and neuro-otological findings . J Neurol Sci . 1987;81:173-184.Crossref 10. Chambers BR, Ell JJ, Gresty MA. Case of downbeat nystagmus influenced by otolith stimulation . Ann Neurol . 1983;13:204-207.Crossref 11. Gresty M, Barratt H, Rudge P, Page N. Analysis of downbeat nystagmus: otolithic vs semicircular canal influences . Arch Neurol . 1986;43:52-55.Crossref 12. Smith R. Vergence eye-movement responses to whole-body linear acceleration stimuli in man . Ophthalmic Physiol Opt . 1985;5:303-311.Crossref 13. Bronstein AM, Gresty MA. Short latency compensatory eye movement responses to transient linear head acceleration: a specific function of the otolith-ocular reflex . Exp Brain Res . 1988;71:406-410.Crossref 14. Kestenbaum A. Clinical Methods of Neuroophthalmologic Examination . London, England: Heinemann Medical Books Ltd; 1948: chap 8 . 15. DeMonchy SH. Rhythmical convergence spasm of the eyes in a case of tumour of the pineal gland . Brain . 1923;46:179-188.Crossref 16. Ochs AL, Stark L, Hoyt WF, D'Amico D. Opposed adducting saccades in convergence-retraction nystagmus . Brain . 1979;102:497-508.Crossref 17. Keane JR. Pretectal pseudobobbing: five patients with 'V'-pattern convergence nystagmus . Arch Neurol . 1985;42:592-594.Crossref 18. Spooner JW, Baloh RW. Arnold-Chiari malformation: improvement in eye movements after surgical treatment . Brain . 1981;104:51-60.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Convergence Nystagmus Associated With Arnold-Chiari Malformation

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Publisher
American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1990.00530030139030
Publisher site
See Article on Publisher Site

Abstract

Abstract • A case of convergence nystagmus associated with an Arnold-Chiari type I malformation is presented. The nystagmus appeared in the absence of fixation, was provoked during Valsalva's maneuver and neck flexion and extension, and attenuated on deep inspiration. Sagittal magnetic resonance images showed that the diameter of the cerebral aqueduct increased with the neck in full flexion and in full extension. Surgical foramen magnum decompression considerably reduced the nystagmus and abolished the postural variation of aqueduct diameter. It is postulated that this nystagmus was due to a combination of mechanical distortion and abnormal transmission of cerebrospinal fluid pressure to the aqueductal region. References 1. Cogan DG. Convergence nystagmus . Arch Ophthalmol . 1959;62:295-299.Crossref 2. Segarra JM, Ojeman RJ. Convergence nystagmus . Neurology . 1961;11:883-893.Crossref 3. Nashold BS, Gills JP, Durham NL. Ocular signs from brain stimulation and lesions . Arch Ophthalmol . 1967;77:609-618.Crossref 4. Keane JR, Davis RL. Pretectal syndrome with metastatic malignant melanoma to the posterior commissure . Am J Ophthalmol . 1976;82:910-914. 5. Christoff N, Anderson PJ, Bender MB. Convergence and retractory nystagmus . Trans Am Neurol Assoc . 1960:29-32. 6. Smith JL, Zieperi L, Gay AJ, Cogan DG. Retractorious . Arch Ophthalmol . 1959;62:864-867.Crossref 7. Baloh RW, Spooner JW. Downbeat nystagmus: a type of central vestibular nystagmus . Neurology . 1981;31:304-310.Crossref 8. Halmagyi GM, Rudge P, Gresty MA, Sanders MD. Downbeating nystagmus: a review of 62 cases . Arch Neurol . 1983;40:777-784. 9. Bronstein AM, Miller DH, Rudge P, Kendall BE. Downbeating nystagmus: magnetic resonance imaging and neuro-otological findings . J Neurol Sci . 1987;81:173-184.Crossref 10. Chambers BR, Ell JJ, Gresty MA. Case of downbeat nystagmus influenced by otolith stimulation . Ann Neurol . 1983;13:204-207.Crossref 11. Gresty M, Barratt H, Rudge P, Page N. Analysis of downbeat nystagmus: otolithic vs semicircular canal influences . Arch Neurol . 1986;43:52-55.Crossref 12. Smith R. Vergence eye-movement responses to whole-body linear acceleration stimuli in man . Ophthalmic Physiol Opt . 1985;5:303-311.Crossref 13. Bronstein AM, Gresty MA. Short latency compensatory eye movement responses to transient linear head acceleration: a specific function of the otolith-ocular reflex . Exp Brain Res . 1988;71:406-410.Crossref 14. Kestenbaum A. Clinical Methods of Neuroophthalmologic Examination . London, England: Heinemann Medical Books Ltd; 1948: chap 8 . 15. DeMonchy SH. Rhythmical convergence spasm of the eyes in a case of tumour of the pineal gland . Brain . 1923;46:179-188.Crossref 16. Ochs AL, Stark L, Hoyt WF, D'Amico D. Opposed adducting saccades in convergence-retraction nystagmus . Brain . 1979;102:497-508.Crossref 17. Keane JR. Pretectal pseudobobbing: five patients with 'V'-pattern convergence nystagmus . Arch Neurol . 1985;42:592-594.Crossref 18. Spooner JW, Baloh RW. Arnold-Chiari malformation: improvement in eye movements after surgical treatment . Brain . 1981;104:51-60.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Mar 1, 1990

References