+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Adult Periodic Alternating Nystagmus Masked by Involuntary Head Movements



Adult Periodic Alternating Nystagmus Masked by Involuntary Head Movements



Frontiers in Neurology 9: 326



Acquired periodic alternating nystagmus (PAN) describes a horizontal jerk nystagmus that reverses its direction with a predictable cycle, and is thought to arise from lesions involving the brainstem and cerebellum. We report a 20-year-old patient with PAN who presented with an acute vertiginous episode and developed an involuntary head movement that initially masked the PAN. The involuntary head movements were abolished with a subtherapeutic dose of botulinum toxin to the neck muscles. We propose that the head movements initially developed as a compensatory movement to the nystagmus, to maintain visual fixation in the presence of the underlying nystagmus, and became an entrained involuntary behavior. This case highlights the importance of disambiguating psychogenic from organic pathology as this may have clinical therapeutic implications, in this case resolution of the most disabling symptom which was her head oscillations, leading to improved day-to-day function despite PAN.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 045232714

Download citation: RISBibTeXText

PMID: 29867735

DOI: 10.3389/fneur.2018.00326


Related references

Sleep in periodic alternating nystagmus its structure and influence on involuntary eye movements. Electroencephalography & Clinical Neurophysiology 60(1): 20P, 1985

Periodic alternating nystagmus and periodic alternating skew deviation in spinocerebellar ataxia type 6. Journal of Neuro-Ophthalmology 28(4): 287-288, 2008

The association of periodic alternating nystagmus with periodic alternating gaze. A case report. Journal of Clinical Neuro-Ophthalmology 1(3): 191-193, 1981

Periodic alternating nystagmus associated with periodic alternating skew deviation. Journal of Clinical Neuro-Ophthalmology 3(2): 115-117, 1983

Periodic Alternating Nystagmus and Congenital Nystagmus: Similarities in Possibly Inherited Cases. Orl 62(1): 53-56, 1999

Periodic alternating nystagmus and congenital nystagmus: similarities in possibly inherited cases. Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties 62(1): 53-56, 2000

The effects of baclofen on periodic alternating nystagmus and experimentally induced nystagmus. Advances in Oto-Rhino-Laryngology 42: 254-259, 1988

The incidence and waveform characteristics of periodic alternating nystagmus in congenital nystagmus. Investigative Ophthalmology & Visual Science 40(11): 2546-2553, 1999

Periodic alternating nystagmus (nystagmus alternans) and excitability of the vestibular system. Archiv für Ohren- Nasen- und Kehlkopfheilkunde 174(3): 182-209, 1959

Alternating spontaneous nystagmus and nystagmus with periodic bursts. Clinical study. Rivista Oto-Neuro-Oftalmologica 43(4): 385-409, 1968

Periodic alternating nystagmus and rebound nystagmus in spinocerebellar ataxia type 6. Movement Disorders 18(10): 1201-1204, 2003

The action of baclofen on periodic alternating nystagmus. Current perspectives in the treatment of certain forms of nystagmus. Bulletins et Memoires de la Societe Francaise d'Ophtalmologie 94: 390-393, 1982

Periodic alternating nystagmus with downward beating nystagmus. A clinicoanatomical case study of multiple sclerosis. Archives of Neurology 30(5): 399-402, 1974

The incidence of periodic alternating nystagmus in motor congenital nystagmus. IOVS 39(4): S908, 1998

Periodic alternating oscillopsia: a symptom of alternating nystagmus abolished by baclofen. Journal of Clinical Neuro-Ophthalmology 10(4): 273-277, 1990