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Episodic Vertical Oscillopsia and Downbeat Nystagmus in a Chiari Malformation

Episodic Vertical Oscillopsia and Downbeat Nystagmus in a Chiari Malformation Abstract • A 36-year-old woman had intermittent downbeat nystagmus. Between episodes of downbeat nystagmus, eye movements were normal, except for stationary positional nystagmus and decreased vestibulo-ocular responses (VOR) to rotation. Smooth pursuit, optokinetic nystagmus, and visual-VOR interactions, which are usually impaired in patients with downbeat nystagmus and cerebellar dysfunction, were normal. Computed tomography and findings during a suboccipital craniotomy demonstrated a mild Chiari malformation, type 1. Episodic downbeat nystagmus that is not associated with other ocular motor abnormalities due to cerebellar dysfunction can be an initial sign of a Chiari malformation. References 1. Baloh RW, Spooner JW: Downbeat nystagmus: A type of central vestibular nystagmus . Neurology 1981;31:304-310.Crossref 2. Cogan DG: Down-beat nystagmus . Arch Ophthalmol 1968;80:758-768. 3. De Barros MC, Farias W, Ataide L, et al: Basilar impression and Arnold-Chiari malformation: A study of 66 cases . J Neurol Neurosurg Psychiatry 1968;31:596-650.Crossref 4. Spooner JW, Baloh RW: Arnold-Chiari malformation: Improvement in eye movements after surgical treatment . Brain 1981;104:51-60.Crossref 5. Peach B: The Arnold-Chiari malformation: Morphogenesis . Arch Neurol 1965;12:527-535.Crossref 6. Baloh RW, Langhofer LR, Honrubia V, et al: On-line analysis of eye movements using a digital computer . Aviat Space Environ Med 1980; 51:563-567. 7. Baloh RW, Honrubia V: Clinical Neurophysiology of the Vestibular System . Philadelphia, FA Davis Co, 1979, p 114. 8. Baloh RW, Yee RD, Kimm J, et al: Vestibulo-ocular reflex in patients with lesions involving the vestibulocerebellum . Exp Neurol 1981; 72:141-152.Crossref 9. Chiari H: Über Veranderungen des Kleinhirns infolge von Hydrocephalie des Grosshirns . Dtsch Med Wochenschr 1891;17:1172-1175.Crossref 10. Chiari H: Über die Veranderungen des Kleinhirns, des Pons und der Medulla oblongata in Folge von congenitaler Hydrocephalie des Grosshirns . Denkschr Akad Wissen Math Naturwissen 1896;63:71-116. 11. Schwalbe E, Gredig M: Über Entwicklungsstorungen des Kleinhirns, Hirnstamms und Halsmarks bei Spina bifida (Arnold Chiarische Missbildung) . Beitr Pathol Anat 1907;40:132-194. 12. Yee RD: Eye movement recording as a clinical tool . Ophthalmology 1983;90:211-222.Crossref 13. Cogan DG, Chu FC, Reingold DB: Ocular signs of cerebellar disease . Arch Ophthalmol 1983; 100:755-760.Crossref 14. Yee RD, Baloh RW, Honrubia V, et al: Slow build-up of optokinetic nystagmus associated with downbeat nystagmus . Invest Ophthalmol Vis Sci 1979;18:622-629. 15. Zee DS: Ocular motor abnormalities related to lesions in the vestibulocerebellum in primate , in Lennerstrand G, Zee DS, Keller EL (eds): Functional Basis of Ocular Motility Disorders . New York, Pergamon Press, 1982, pp 423-430. 16. Zee DS, Friendlich A, Robinson DA: The mechanism of downbeat nystagmus . Arch Neurol 1974; 30:227-237.Crossref 17. Baloh RW, Sakala SM, Honrubia V: Benign paroxysmal positional nystagmus . Am J Otolaryngol 1979;1:1-5.Crossref 18. Pederson RA, Troost BT, Abel LA, et al: Intermittent downbeat nystagmus and oscillopsia reversed by suboccipital craniectomy . Neurology 1980;30:1239-1242.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Episodic Vertical Oscillopsia and Downbeat Nystagmus in a Chiari Malformation

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Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1984.01040030579023
Publisher site
See Article on Publisher Site

Abstract

Abstract • A 36-year-old woman had intermittent downbeat nystagmus. Between episodes of downbeat nystagmus, eye movements were normal, except for stationary positional nystagmus and decreased vestibulo-ocular responses (VOR) to rotation. Smooth pursuit, optokinetic nystagmus, and visual-VOR interactions, which are usually impaired in patients with downbeat nystagmus and cerebellar dysfunction, were normal. Computed tomography and findings during a suboccipital craniotomy demonstrated a mild Chiari malformation, type 1. Episodic downbeat nystagmus that is not associated with other ocular motor abnormalities due to cerebellar dysfunction can be an initial sign of a Chiari malformation. References 1. Baloh RW, Spooner JW: Downbeat nystagmus: A type of central vestibular nystagmus . Neurology 1981;31:304-310.Crossref 2. Cogan DG: Down-beat nystagmus . Arch Ophthalmol 1968;80:758-768. 3. De Barros MC, Farias W, Ataide L, et al: Basilar impression and Arnold-Chiari malformation: A study of 66 cases . J Neurol Neurosurg Psychiatry 1968;31:596-650.Crossref 4. Spooner JW, Baloh RW: Arnold-Chiari malformation: Improvement in eye movements after surgical treatment . Brain 1981;104:51-60.Crossref 5. Peach B: The Arnold-Chiari malformation: Morphogenesis . Arch Neurol 1965;12:527-535.Crossref 6. Baloh RW, Langhofer LR, Honrubia V, et al: On-line analysis of eye movements using a digital computer . Aviat Space Environ Med 1980; 51:563-567. 7. Baloh RW, Honrubia V: Clinical Neurophysiology of the Vestibular System . Philadelphia, FA Davis Co, 1979, p 114. 8. Baloh RW, Yee RD, Kimm J, et al: Vestibulo-ocular reflex in patients with lesions involving the vestibulocerebellum . Exp Neurol 1981; 72:141-152.Crossref 9. Chiari H: Über Veranderungen des Kleinhirns infolge von Hydrocephalie des Grosshirns . Dtsch Med Wochenschr 1891;17:1172-1175.Crossref 10. Chiari H: Über die Veranderungen des Kleinhirns, des Pons und der Medulla oblongata in Folge von congenitaler Hydrocephalie des Grosshirns . Denkschr Akad Wissen Math Naturwissen 1896;63:71-116. 11. Schwalbe E, Gredig M: Über Entwicklungsstorungen des Kleinhirns, Hirnstamms und Halsmarks bei Spina bifida (Arnold Chiarische Missbildung) . Beitr Pathol Anat 1907;40:132-194. 12. Yee RD: Eye movement recording as a clinical tool . Ophthalmology 1983;90:211-222.Crossref 13. Cogan DG, Chu FC, Reingold DB: Ocular signs of cerebellar disease . Arch Ophthalmol 1983; 100:755-760.Crossref 14. Yee RD, Baloh RW, Honrubia V, et al: Slow build-up of optokinetic nystagmus associated with downbeat nystagmus . Invest Ophthalmol Vis Sci 1979;18:622-629. 15. Zee DS: Ocular motor abnormalities related to lesions in the vestibulocerebellum in primate , in Lennerstrand G, Zee DS, Keller EL (eds): Functional Basis of Ocular Motility Disorders . New York, Pergamon Press, 1982, pp 423-430. 16. Zee DS, Friendlich A, Robinson DA: The mechanism of downbeat nystagmus . Arch Neurol 1974; 30:227-237.Crossref 17. Baloh RW, Sakala SM, Honrubia V: Benign paroxysmal positional nystagmus . Am J Otolaryngol 1979;1:1-5.Crossref 18. Pederson RA, Troost BT, Abel LA, et al: Intermittent downbeat nystagmus and oscillopsia reversed by suboccipital craniectomy . Neurology 1980;30:1239-1242.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: May 1, 1984

References