title: Degree of tectal beaking correlates to the presence of nystagmus in children with Chiari II malformation.
abstract: BACKGROUND
  Tectal beaking is a common finding in children born with a myelomeningocele. Quantitation of the presence or absence of this finding correlated with normal or abnormal eye movements is lacking in the medical literature.
  
  
  METHODS
  We prospectively evaluated 50 children in our multidisciplinary spina bifida clinic. Each child was observed for the presence or absence of nystagmus at rest or with extraocular movement. Grades of nystagmus and severity of tectal beaking (Types I-III) on MRI were then correlated.
  
  
  RESULTS
  Overwhelmingly, children with greater dysmorphology of the mesencephalic tectum were most likely to have nystagmus. Higher grades of nystagmus were associated with Type III tectal beaking.
  
  
  CONCLUSIONS
  We have demonstrated that there is a correlation between the presence and severity of nystagmus and the severity of tectal beaking and have quantified this association in patients with the Chiari II malformation. This information may act as a guide in predicting which children with the Chiari II malformation will have significant nystagmus. These data may aid the clinician in the interpretation of oculomotor abnormalities in this cohort of patients.
authors.affiliation: Department of Cell Biology, University of Alabama at Birmingham, Birmingham, USA. richard.tubbs@ccc.uab.edu
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.forename: Scott
authors.initials: S
authors.lastname: Soleau
authors.forename: James
authors.initials: J
authors.lastname: Custis
authors.forename: John C
authors.initials: JC
authors.lastname: Wellons
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Blount
authors.forename: W Jerry
authors.initials: WJ
authors.lastname: Oakes
mesh_terms: D000293:Adolescent; D001139:Arnold-Chiari Malformation / Q000473:pathology* / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009759:Nystagmus, Pathologic / Q000209:etiology*; D011446:Prospective Studies; D003336:Tectum Mesencephali / Q000473:pathology* / Q000503:physiopathology