title: Perverted head-shaking nystagmus: a possible mechanism.
abstract: The authors describe a patient with acute MS who developed vertigo (tumbling) and downbeat nystagmus upon horizontal head oscillation (perverted head-shaking nystagmus). The only abnormality on brain MRI was a hyperintense signal in the caudal medulla that contains the nucleus Roller and nucleus intercalatus. These nuclei project to structures involved in the velocity storage system for horizontal vestibulocular reflex (VOR) and vertical VOR, and also to the vestibular cerebellum. The authors offer possible mechanisms for perverted nystagmus in this patient.
authors.affiliation: Department of Neurology, University of Miami School of Medicine, FL, USA.
authors.forename: A
authors.initials: A
authors.lastname: Minagar
authors.forename: W A
authors.initials: WA
authors.lastname: Sheremata
authors.forename: R J
authors.initials: RJ
authors.lastname: Tusa
mesh_terms: D000328:Adult; D005260:Female; D019416:Head Movements / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008526:Medulla Oblongata / Q000473:pathology*; D009103:Multiple Sclerosis / Q000150:complications / Q000473:pathology*; D009759:Nystagmus, Pathologic / Q000150:complications / Q000473:pathology*; D012027:Reflex, Vestibulo-Ocular / Q000502:physiology