Episodic vertical oscillopsia and downbeat nystagmus in a Chiari malformation.
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.
D000328:Adult; D001139:Arnold-Chiari Malformation / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D004584:Electronystagmography; D005133:Eye Movements; D005260:Female; D006801:Humans; D009759:Nystagmus, Pathologic / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D014724:Vestibular Function Tests; D014786:Vision Disorders / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy