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Upbeat nystagmus changes to downbeat nystagmus with upward gaze in a patient with Wernicke's encephalopathy

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Author(s)
Byoung-Soo ShinSun-Young OhJi Soo KimHyung LeeEui-Jung KimSeung-Bae Hwang
Keimyung Author(s)
Lee, Hyung
Department
Dept. of Neurology (신경과학)
Journal Title
Journal of the Neurological Sciences
Issued Date
2010
Volume
298
Issue
1-2
Keyword
Upbeat nystagmusWernicke's encephalopathyNeural integratorSmooth pursuit
Abstract
We describe a patient with Wernicke's encephalopathy who showed spontaneous upbeat nystagmus with decelerating slow phases that changed to downbeat nystagmus during upward gaze and increased during downward gaze. He also showed horizontal gaze-evoked nystagmus and impaired upward smooth pursuit. Magnetic resonance imaging demonstrated symmetric lesions involving the bilateral medial thalami, periaqueductal gray matters and inferior cerebellar peduncles. In this patient, the decelerating slow phases and disobedience to Alexander's law of upbeat nystagmus suggest both deficient (leaky) and unstable neural integrators subserving vertical eye motion. Dysfunction of the interstitial nucleus of Cajal or its descending pathway to the vestibulocerebellum via the paramedian tract cell groups may be responsible for the upbeat nystagmus and its modulation by gazes in our patient with Wernicke's encephalopathy.
Keimyung Author(s)(Kor)
이형
Publisher
School of Medicine
Citation
Byoung-Soo Shin et al. (2010). Upbeat nystagmus changes to downbeat nystagmus with upward gaze in a patient with Wernicke’s encephalopathy. Journal of the Neurological Sciences, 298(1–2), 145–147. doi: 10.1016/j.jns.2010.08.012
Type
Article
ISSN
0022-510X
Source
https://www.sciencedirect.com/science/article/pii/S0022510X10003618?via%3Dihub
DOI
10.1016/j.jns.2010.08.012
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34296
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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