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Intermittent downbeat nystagmus and oscillopsia reversed by suboccipital craniectomy

Neurologic Control System Laboratory, Neurology Service (Drs. Troost and Abel), Veterans Administration Medical Center, and the Departments of Neurology (Drs. Pedersen, Troost, and Abel) and Neurosurgery (Dr. Zorub), University of Pittsburgh School of Medicine, Pittsburgh, PA.

We describe an unusual case of vertical oscillopsia and primary position downbeat nystagmus associated with an adult Arnold-Chiari malformation. A unique aspect of the ocular motor abnormality was the intermittent nature of the nystagmus, which displayed no relationship to head position, emotion, or the Valsalva maneuver. Conventional computed tomography with posterior fossa views was normal, but metrizamide cisternography demonstrated an extramedullary mass originally believed to be a meningioma. There was a dramatic diminution of the visual comdaints and downbeat nvstamus after suboccipital craniectomy for an Arnold-Chiari malformation. Nystagmus characteristics were documented by serial quantitative eye movement recordings.

Address correspondence and reprint requests to Dr. Troost, Veterans Administration Medical Center (127), 10701 E. Blvd., Cleveland, OH 44106.

Accepted for publication January 18, 1980.

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