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Pearls & Oy-sters: Vibration-Induced Downbeat Nystagmus: A New Cerebellar Sign Observed in Paraneoplastic Syndrome.
Neurology
January 2023
From the Research Administration Team (Hyo-Jung Kim), Seoul National University Bundang Hospital, Seongnam, Korea; Department of Neurology (Hyun-Jae Kim), Chungbuk National University Hospital, Cheongju, Korea; Dizziness Center (J.-H.L., J.-S.K.), Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Korea; and Department of Neurology (J.-S.K.), Seoul National University College of Medicine, Korea.
Vibratory stimulation of the sternocleidomastoid muscles or the skull may enhance vestibular asymmetry and evoke nystagmus. We report prominent downbeating vibration-induced nystagmus (VIN) in a patient with paraneoplastic cerebellar degeneration due to cervical cancer with positive serum anti-Ri antibody. A 47-year-old woman developed spontaneous upbeat nystagmus present with and without visual fixation.
View Article and Find Full Text PDFAnti-Ma-associated paraneoplastic cerebellar degeneration in a patient with nodular lymphocyte-predominant Hodgkin lymphoma: a case report.
BMC Neurol
September 2020
Department of Hematology, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan.
Article Synopsis
- Paraneoplastic cerebellar degeneration (PCD) can occur in patients with Hodgkin lymphoma, specifically linked to the anti-Ma2 onconeuronal antibody, with only one previous case documented.
- A 77-year-old man exhibited symptoms of gait instability and oscillopsia, leading to a diagnosis of nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) after tests confirmed the presence of the anti-Ma2 antibody.
- This case is notable as it presents the first documented instance of anti-Ma2-associated PCD in NLPHL, validated by immunostaining of the lymph node cells.
Magnetic Oculomotor Prosthetics for Acquired Nystagmus.
Ophthalmology
October 2017
Department of Clinical Neurology, University of Oxford, Oxford, United Kingdom.
Purpose: Acquired nystagmus, a highly symptomatic consequence of damage to the substrates of oculomotor control, often is resistant to pharmacotherapy. Although heterogeneous in its neural cause, its expression is unified at the effector-the eye muscles themselves-where physical damping of the oscillation offers an alternative approach. Because direct surgical fixation would immobilize the globe, action at a distance is required to damp the oscillation at the point of fixation, allowing unhindered gaze shifts at other times.
View Article and Find Full Text PDFUpbeat nystagmus in anti-Ma2 encephalitis.
Pract Neurol
February 2014
Atkinson Morley Neuroscience Unit, St George's Hospital, , London, UK.
Anti-Ma2 encephalitis is a paraneoplastic disorder characterised by brainstem and/or limbic involvement. Eye movement abnormalities can occur in this condition, often with confusion or somnolence. We describe a patient with progressive oscillopsia (with upbeat nystagmus) and unsteadiness, followed by acute pancreatitis.
View Article and Find Full Text PDFParaneoplastic disorders of eye movements.
Ann N Y Acad Sci
September 2011
Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Paraneoplastic syndromes affecting the brainstem and cerebellum are reported to cause a variety of abnormalities of eye movements. Recent studies have begun to account for the mechanisms underlying several syndromes, characterized by opsoclonus, slow, or dysmetric saccades, as well as downbeat nystagmus. We provide evidence that upbeat nystagmus in a female patient with pancreatic cancer reflected a cerebellar-induced imbalance of otolithic pathways: she showed marked retropulsion, and her nystagmus was dependent on head position, being absent when supine, and suppressed with convergence.
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