Ataxia and Oscillopsia in Downbeat-Nystagmus Vertigo Syndrome1

Büchele, W; Brandt, Thomas; Degner, D

doi:10.1159/000407661

Cited by 38 publications

(22 citation statements)

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“…This finding confirms previously reported data on impairments in motion perception in patients with nystagmus. [22][23][24] In addition, fixation areas of children with infantile nystagmus syndrome were significantly larger, confirming fixation instabilities in this group. Children with cerebral visual impairment often present with deficits in the input of visual information, for example, nystagmus or other eye movement abnormalities.…”

Section: Discussionmentioning

confidence: 84%

Orienting Responses to Various Visual Stimuli in Children With Visual Processing Impairments or Infantile Nystagmus Syndrome

Pel¹,

Kooiker²,

Does³

et al. 2013

J Child Neurol

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Quantification of orienting responses can be used to differentiate between children with cerebral visual impairment and infantile nystagmus syndrome. To further improve the sensitivity of this method, we compared orienting responses to a Cartoon stimulus, which contains all sorts of visual information, to stimuli that contain only Contrast, Form coherence, Motion coherence, Color and Motion detection. The stimuli were shown on an eye tracker monitor using a preferential looking paradigm. We found that both groups of children showed general slowing in orienting responses compared to controls. The children with cerebral visual impairment had significantly prolonged responses to Cartoon compared to the children with nystagmus, whereas the children with nystagmus had prolonged responses to Motion detection and larger fixation areas. Previously reported differences in orienting responses to Cartoon were replicated. Application of specific visual information did not alter the sensitivity of the method to distinguish between children with visual processing deficits.

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Section: Discussionmentioning

confidence: 84%

Orienting Responses to Various Visual Stimuli in Children With Visual Processing Impairments or Infantile Nystagmus Syndrome

Pel¹,

Kooiker²,

Does³

et al. 2013

J Child Neurol

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“…Body sway increased together with nystagmus intensity in patients with pathologic downbeat nystagmus while the patients tried to fixate an eccentric target. 7 Because both sway and nystagmus could be driven by the same vestibular input, this result was taken as support for the hypothesis that downbeat nystagmus is a vestibular syndrome, an assumption that has recently been questioned. 8 All of the above findings can also be explained by the direct influence of eye movements on postural control.…”

mentioning

confidence: 72%

A synovial cyst in the cervical spine causing acute spinal cord compression

McGuigan

Stevens²,

Gabriel³

2005

Neurology

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Abstract-The increased postural sway of patients with disorders of the vestibular system improves with vision. The suppression of pathologic nystagmus also reduces sway. Because the latter effect cannot be attributed to retinal slip as a relevant feedback for postural control, the authors investigated how eye movements rather than retinal slip affect balance. They found that slow eye movements increase sway, possibly by an efference copy, which explains why spontaneous nystagmus causes postural imbalance. NEUROLOGY 2005;65:1291-1293 S. Glasauer, PhD; E. Schneider, PhD; K. Jahn, MD; M. Strupp, MD; and T. Brandt, MD Balance control depends on the integrity of various sensory and motor systems. Increased body sway is found in patients with vestibular, proprioceptive, and cerebellar disorders. However, if visual input is sufficient, the postural stability of most patients is restored to normal levels. This can easily be demonstrated in healthy subjects by having them close their eyes while assuming an unstable posture, e.g., with feet in the heel-to-toe position.What is the visual cue for postural stabilization? Comparing posture in darkness and posture with vision of stable space-fixed targets or with full-field vision revealed a significant increase in stability with vision.1 Large-field moving visual scenes were found to cause body sway in the same direction as stimulus motion.2 Only a few studies 3-5 have tried to determine which visually derived signal may be used for the motor control of body sway. On the basis of the available experimental data, it is commonly believed that retinal slip, i.e., target or background motion on the retina, is the afferent signal that determines visually evoked postural responses. However, during fixation of a space-fixed target, retinal slip is minimized by the vestibulo-ocular reflex and visual smooth pursuit. Therefore, eye movement rather than retinal slip reflects head motion in space. Is it conceivable that eye movement signals, efferent or reafferent, are used for the motor control of postural sway? Here we provide evidence that slow eye movements in the absence of substantial retinal slip can significantly affect postural stability.Methods. Healthy subjects (six women, nine men; aged 22 to 45 years) standing heel-to-toe on a force-measuring platform (Kistler 9284) were asked to fixate a target spot on a translucent screen 0.7 m in front of them (lateral field of view 94°). Eye and head movements were monitored by video-oculography (lateral field of view of goggles 74°) and head position tracking (Intersense IS-600). After giving their informed consent, the subjects were asked to stand as stable as possible during nine randomized conditions. Fixation conditions included the following: standing in complete darkness and looking straight ahead (F1); fixation of a stationary target in darkness (F2) and fixation of a stationary target on a moving background (F3). Eye movement conditions were as follows: pursuing a moving target in darkness (E1); pursuing a moving target on a sta...

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“…These patients had an associated relative central field defect and poor colour vision. (2) Severe titubation (patients 5,9). Such patients need their VOR to stabilise their eyes; RIS would relieve them of oscillopsia due to nystagmus, but replace it with oscillopsia due to titubation.…”

Section: Resultsmentioning

confidence: 99%

“…Some of these patients had a coarse nystagmus with a correspondingly slow oscillopsia, which they could "see through" (patients 2,7,8,9,13). In addition, those with an ataxic (2,9), gazeparetic (7,8,13) or periodic alternating nystagmus (10), had a good null point or area, which they had learned to capture and use. Patient 3 with a coarse pendular congenital nystagmus had only slight or intermittent oscillopsia in spite of his obvious nystagmus.…”

Section: Resultsmentioning

confidence: 99%

“…Rushton, Cox lopsia, such as a raised perceptual threshold, or reduced sensitivity.8 9 Patients whose oscillopsia amplitude is less than would be predicted from the amplitude of nystagmus then require only partial retinal image stabilisation (RIS) in order to eliminate oscillopsia by supplementing their central cancellation. In them it is necessary to measure the angular size ("N") of the nystagmus, and the angular size ("O") of the oscillopsia and compare the two to see how much RIS is needed.…”

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confidence: 99%

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