Download PDF
Nervenheilkunde 2009; 28(01/02): 31-35
DOI: 10.1055/s-0038-1628572
Thema zum Schwerpunkt
Schattauer GmbH

Downbeat und Upbeat Nystagmus

Downbeat and upbeat nystagmus
J. Wagner
1   Klinikum Grosshadern, Abteilung für Neurologie, Ludwig-Maximilians-Universität München
,
R. Kalla
1   Klinikum Grosshadern, Abteilung für Neurologie, Ludwig-Maximilians-Universität München
,
K. Hüfner
1   Klinikum Grosshadern, Abteilung für Neurologie, Ludwig-Maximilians-Universität München
,
M. Glaser
1   Klinikum Grosshadern, Abteilung für Neurologie, Ludwig-Maximilians-Universität München
,
S. Glasauer
2   Bernstein Zentrum für Computational Neuroscience, München
,
T. Brandt
1   Klinikum Grosshadern, Abteilung für Neurologie, Ludwig-Maximilians-Universität München
,
M. Strupp
1   Klinikum Grosshadern, Abteilung für Neurologie, Ludwig-Maximilians-Universität München
› Author Affiliations
Further Information

Publication History

Eingegangen am: 01 August 2008

angenommen am: 08 August 2008

Publication Date:
23 January 2018 (online)

    Permissions and Reprints

Zusammenfassung

Vertikaler Nystagmus ist ein klinisches Zeichen einer zentralen Läsion. Downbeat und Upbeat Nystagmus unterscheiden sich jedoch bezüglich Lokalisation, Ätiologie, Pathophysiologie und Prognose. Diese sowie die aktuellen Therapieansätze sollen im folgenden Übersichtsartikel dargestellt werden.

Summary

Vertical nystagmus is a clinical sign of a central lesion. Downbeat and upbeat nystagmus differ regarding localization, aetiology, pathophysiology and prognosis. These – as well as therapeutic options – will be discussed in this review.

Schlüsselwörter

Zerebellum - Nystagmus - Hirnstamm - Flocculus

Keywords

Cerebellum - nystagmus - brainstem - flocculus
 

  • Literatur

  • 1 Leigh RJ, Zee DS. Nystagmus due to vestibular imbalance. In: Leigh RJ, Zee DS. The neurology of eye movements. Philadelphia: Davis; 2006: 480-9.
    Google Scholar
  • 2 Akdal G. et al. Eye movement disorders in vitamin B12 deficiency: two new cases and a review of the literature. Eur J Neurol 2007; 14 (10) 1170-2.
    CrossrefPubMedGoogle Scholar
  • 3 Surges R. et al. Sudden bilateral blindness in Wernicke’s encephalopathy: case report and review of the literature. J Neurol Sci 2007; 260 (1–2): 261-4.
    CrossrefPubMedGoogle Scholar
  • 4 Shinmei Y. et al. Ocular motor disorders in mitochondrial encephalopathy with lactic acid and stroke-like episodes with the 3271 (T-C) point mutation in mitochondrial DNA. J Neuroophthalmol 2007; 27 (01) 22-8.
    CrossrefPubMedGoogle Scholar
  • 5 Antonini G. et al. Autoantibodies to glutamic acid decarboxylase in downbeat nystagmus. J Neurol Neurosurg Psychiatry 2003; 74 (07) 998-9.
    CrossrefPubMedGoogle Scholar
  • 6 Zivotofsky AZ. et al. A rare saccade velocity profile in Stiff-Person Syndrome with cerebellar degeneration. Brain Res 2006; 1093 (01) 135-40.
    CrossrefPubMedGoogle Scholar
  • 7 Tilikete C. et al. Potential role of anti-GAD antibodies in abnormal eye movements. Ann N Y Acad Sci 2005; 1039: 446-54.
    CrossrefPubMedGoogle Scholar
  • 8 Mitoma H. et al. Presynaptic impairment of cerebellar inhibitory synapses by an autoantibody to glutamate decarboxylase. J Neurol Sci 2000; 175 (01) 40-4.
    CrossrefPubMedGoogle Scholar
  • 9 Kattah JC, Gujrati M. Familial positional downbeat nystagmus and cerebellar ataxia: clinical and pathologic findings. Ann N Y Acad Sci 2005; 1039: 540-3.
    CrossrefPubMedGoogle Scholar
  • 10 van Rootselaar AF. et al. Decreased cortical inhibition and yet cerebellar pathology in ‘familial cortical myoclonic tremor with epilepsy’. Mov Disord 2007; 22 (16) 2378-85.
    CrossrefPubMedGoogle Scholar
  • 11 Thakore NJ. et al. Motor neuronopathy with dropped hands and downbeat nystagmus: a distinctive disorder? A case report. BMC Neurol 2006; 06: 3.
    CrossrefPubMedGoogle Scholar
  • 12 Du P. et al. Periodic downbeat nystagmus. Neurology 1998; 51 (05) 1478-80.
    CrossrefPubMedGoogle Scholar
  • 13 Bixenman WW. Congenital hereditary downbeat nystagmus. Can J Ophthalmol 1983; 18 (07) 344-8.
    PubMedGoogle Scholar
  • 14 Hufner K. et al. Structural and functional MRIs disclose cerebellar pathologies in idiopathic downbeat nystagmus. Neurology 2007; 69 (11) 1128-35.
    CrossrefPubMedGoogle Scholar
  • 15 Zee DS. et al. Effects of ablation of flocculus and paraflocculus of eye movements in primate. J Neurophysiol 1981; 46 (04) 878-99.
    CrossrefPubMedGoogle Scholar
  • 16 Cogan DG, Barrows LJ. Platybasia and the ArnoldChiari malformation. AMA Arch Ophthalmol 1954; 52 (01) 13-29.
    CrossrefPubMedGoogle Scholar
  • 17 Malis LI. et al. Arnold-Chiari malformation. AMA Arch Surg 1951; 63 (06) 783-98.
    CrossrefPubMedGoogle Scholar
  • 18 Bense S. et al. 18F-fluorodeoxyglucose hypometabolism in cerebellar tonsil and flocculus in downbeat nystagmus. Neuroreport 2006; 17 (06) 599-603.
    CrossrefPubMedGoogle Scholar
  • 19 Bohmer A, Straumann D. Pathomechanism of mammalian downbeat nystagmus due to cerebellar lesion: a simple hypothesis. Neurosci Lett 1998; 250 (02) 127-30.
    CrossrefPubMedGoogle Scholar
  • 20 Gresty H. et al. Analysis of downbeat nystagmus. Otolithic vs semicircular canal influences. Arch Neurol 1986; 43 (01) 52-5.
    PubMedGoogle Scholar
  • 21 Zee DS. et al. The mechanism of downbeat nystagmus. Arch Neurol 1974; 30 (03) 227-37.
    CrossrefPubMedGoogle Scholar
  • 22 Pierrot-Deseilligny C, Milea D. Vertical nystagmus: clinical facts and hypotheses. Brain 2005; 128 (Pt 6): 1237-46.
    CrossrefPubMedGoogle Scholar
  • 23 Glasauer S. et al. Three-dimensional eye position and slow phase velocity in humans with downbeat nystagmus. J Neurophysiol 2003; 89 (01) 338-54.
    CrossrefPubMedGoogle Scholar
  • 24 Bertholon P. et al. [Post-traumatic syringomyelobulbia and inferior vertical nystagmus]. Rev Neurol (Paris) 1993; 149 (05) 355-8.
    PubMedGoogle Scholar
  • 25 Rousseaux M. et al. Upbeat and downbeat nystagmus occurring successively in a patient with posterior medullary haemorrhage. J Neurol Neurosurg Psychiatry 1991; 54 (04) 367-9.
    CrossrefPubMedGoogle Scholar
  • 26 Jacobson DM, Corbett JJ. Downbeat nystagmus and dolichoectasia of the vertebrobasilar artery. J Neuroophthalmol 2002; 22 (02) 150-1.
    CrossrefPubMedGoogle Scholar
  • 27 Lee AG. Downbeat nystagmus associated with caudal brainstem compression by the vertebral artery. J Neuroophthalmol 2001; 21 (03) 219-20.
    CrossrefPubMedGoogle Scholar
  • 28 Himi T. et al. Downbeat nystagmus with compression of the medulla oblongata by the dolichoectatic vertebral arteries. Am J Otol 1995; 16 (03) 377-81.
    Google Scholar
  • 29 Buchele W, Brandt T, Degner D. Ataxia and oscillopsia in downbeat-nystagmus vertigo syndrome. Adv Otorhinolaryngol 1983; 30: 291-7.
    PubMedGoogle Scholar
  • 30 Cogan DG. Down-beat nystagmus. Arch Ophthalmol 1968; 80 (06) 757-68.
    CrossrefPubMedGoogle Scholar
  • 31 Halmagyi GM. et al. Downbeating nystagmus. A review of 62 cases. Arch Neurol 1983; 40 (13) 777-84.
    PubMedGoogle Scholar
  • 32 Baloh RW, Yee RD. Spontaneous vertical nystagmus. Rev Neurol (Paris) 1989; 145 (8–9): 527-32.
    PubMedGoogle Scholar
  • 33 Strupp M. et al. Treatment of downbeat nystagmus with 3,4-diaminopyridine: a placebo-controlled study. Neurology 2003; 61 (02) 165-70.
    CrossrefPubMedGoogle Scholar
  • 34 Kalla R. et al. 4-aminopyridine improves downbeat nystagmus, smooth pursuit, and VOR gain. Neurology 2004; 62 (07) 1228-9.
    CrossrefPubMedGoogle Scholar
  • 35 Helmchen C. et al. Beneficial effects of 3,4-diaminopyridine on positioning downbeat nystagmus in a circumscribed uvulo-nodular lesion. J Neurol 2007; 254 (08) 1126-8.
    CrossrefPubMedGoogle Scholar
  • 36 Kalla R. et al. 4-aminopyridine restores vertical and horizontal neural integrator function in downbeat nystagmus. Brain 2007; 130 (Pt 9): 2441-51.
    CrossrefPubMedGoogle Scholar
  • 37 Young YH, Huang TW. Role of clonazepam in the treatment of idiopathic downbeat nystagmus. Laryngoscope 2008; 111 (08) 1490-3.
    Google Scholar
  • 38 Currie JN, Matsuo V. The use of clonazepam in the treatment of nystagmus-induced oscillopsia. Ophthalmology 1986; 93 (07) 924-32.
    CrossrefPubMedGoogle Scholar
  • 39 verbuch-Heller L. et al. A double-blind controlled study of gabapentin and baclofen as treatment for acquired nystagmus. Ann Neurol 1997; 41 (06) 818-25.
    CrossrefPubMedGoogle Scholar
  • 40 Dieterich M. et al. The effects of baclofen and cholinergic drugs on upbeat and downbeat nystagmus. J Neurol Neurosurg Psychiatry 1991; 54 (07) 627-32.
    CrossrefPubMedGoogle Scholar
  • 41 Barton JJ, Huaman AG, Sharpe JA. Muscarinic antagonists in the treatment of acquired pendular and downbeat nystagmus: a double-blind, randomized trial of three intravenous drugs. Ann Neurol 1994; 35 (03) 319-25.
    CrossrefPubMedGoogle Scholar
  • 42 Kumar A, Patni AH, Charbel F. The Chiari I malformation and the neurotologist. Otol Neurotol 2002; 23 (05) 727-35.
    CrossrefPubMedGoogle Scholar
  • 43 Vulliemoz S. et al. Epilepsy and cerebellar ataxia associated with anti-glutamic acid decarboxylase antibodies. J Neurol Neurosurg Psychiatry 2007; 78 (02) 187-9.
    CrossrefPubMedGoogle Scholar
  • 44 Kaseda Y. et al. Spinocerebellar ataxia type 6 in relation to CAG repeat length. Acta Neurol Scand 1999; 99 (04) 209-12.
    CrossrefPubMedGoogle Scholar
  • 45 Yoon CK, Chang MH, Lee DC. Wernicke-Korsakoff syndrome associated with hyperemesis gravidarum. Korean J Ophthalmol 2005; 19 (03) 239-42.
    CrossrefPubMedGoogle Scholar
  • 46 Zingler VC. et al. Upbeat nystagmus as the initial clinical sign of Creutzfeldt-Jakob disease. Ann Neurol 2005; 57 (04) 607-8.
    CrossrefPubMedGoogle Scholar
  • 47 Jay WM, Marcus RW, Jay MS. Primary position upbeat nystagmus with organophosphate poisoning. J Pediatr Ophthalmol Strabismus 1982; 19 (06) 318-9.
    PubMedGoogle Scholar
  • 48 Pereira CB. et al. Smoking and balance: correlation of nicotine-induced nystagmus and postural body sway. Neuroreport 2001; 12 (06) 1223-6.
    CrossrefPubMedGoogle Scholar
  • 49 Sibony PA, Evinger C, Manning KA. Tobacco-induced primary-position upbeat nystagmus. Ann Neurol 1987; 21 (01) 53-8.
    CrossrefPubMedGoogle Scholar
  • 50 Glasauer S. et al. 4-aminopyridine restores visual ocular motor function in upbeat nystagmus. J Neurol Neurosurg Psychiatry 2005; 76 (03) 451-3.
    CrossrefPubMedGoogle Scholar
  • 51 Glasauer S. et al. Effect of 4-aminopyridine on upbeat and downbeat nystagmus elucidates the mechanism of downbeat nystagmus. Ann N Y Acad Sci 2005; 1039: 528-31.
    CrossrefPubMedGoogle Scholar
  • 52 Wagner JN. et al. Downbeat nystagmus: aetiology and comorbidity in 117 patients. J Neurol Neurosurg Psychiatry 2008; 79 (06) 672-7.
    PubMedGoogle Scholar