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- W403928596 abstract "OBJECTIVE: To investigate the vertical translational vestibulo-ocular reflex (vTVOR) in a patient with idiopathic downbeat nystagmus (DBN). BACKGROUND: DBN may occur in the context of a broader cerebellar syndrome or as an isolated finding. Asymmetry of otolith-mediated vestibular reflexes has been proposed as a possible cause of DBN. Here we present a patient with idiopathic DBN who had a robust vTVOR during downward but not upward translation.A 70-year-old woman presented with progressive oscillopsia and DBN for several years. The ocular motility examination was otherwise normal other than impaired downward pursuit. There was no limb or gait ataxia. There was no family history of a similar disorder, and laboratory studies failed to identify an underlying cause. MRI showed mild atrophy of the cerebellar vermis. DESIGN/METHODS: We recorded the vTVOR on a motion platform, in response to 2 Hz oscillation, abrupt position steps, and a sum-of-sines stimulus. We also measured the vertical rotational VOR (vRVOR) and visual tracking at 1 and 2 Hz. RESULTS: For all translation stimuli, the vTVOR was asymmetric: only upward slow phases were evoked. In contrast, the vRVOR was symmetric. Tracking of 1 Hz visual stimuli was also asymmetric (upward slow phases only), but there was little response to either direction of visual motion at 2 Hz. Thus, the preserved upward slow phases during vertical translation cannot be attributed simply to visual tracking. CONCLUSIONS: Most patients with DBN due to cerebellar degeneration lose the vTVOR for both directions of translation, but isolated DBN may be associated with an asymmetric vTVOR. The findings provide further evidence for a close relationship between the TVOR and visual tracking, and they support a vertical asymmetry in these systems as one possible cause of DBN. Study Supported by: Department of Veterans Affairs, Armington Fund Disclosure: Dr. Walker has nothing to disclose. Dr. Serra has nothing to disclose." @default.
- W403928596 created "2016-06-24" @default.
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- W403928596 date "2015-04-06" @default.
- W403928596 modified "2023-09-23" @default.
- W403928596 title "Asymmetry of the Vertical Translational Vestibulo-Ocular Reflex in Idiopathic Downbeat Nystagmus (P5.309)" @default.
- W403928596 hasPublicationYear "2015" @default.
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