Skip Navigation
Skip to contents

Res Vestib Sci : Research in Vestibular Science

OPEN ACCESS
SEARCH
Search
Advanced Search
mobile menu button

Articles

Page Path
HOME > Res Vestib Sci > Volume 23(2); 2024 > Article
Video Report
Aperiodic alternating nystagmus in acute lateral medullary infarction: a video report
Ji-Yun Parkorcid
Research in Vestibular Science 2024;23(2):61-62.
DOI: https://doi.org/10.21790/rvs.2024.010
Published online: June 14, 2024

Department of Neurology, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Korea

Corresponding author: Ji-Yun Park Department of Neurology, Ulsan University Hospital, Ulsan University Medical School, 25 Daehakbyeongwon-ro, Dong-gu, Ulsan 44033, Korea E-mail: bingbing@uuh.ulsan.kr
• Received: June 3, 2024   • Revised: June 11, 2024   • Accepted: June 12, 2024

© 2024 The Korean Balance Society

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • 883 Views
  • 16 Download
prev
Full Article

Download PDF Download PDF

An 81-year-old man presented with acute vertigo, left tilt, and headache for 1 day. Neurologic examination revealed spontaneous waxing and waning nystagmus with horizontal directional changes with omnidirectional gaze-evoked nystagmus and vigorous left-beating nystagmus on the head-shaking test. Diffusion-weighted magnetic resonance imaging demonstrated an acute infarction involving the left lateral medulla (Fig. 1A). Videooculography showed aperiodic alternating nystagmus (aPAN) with an irregular interval (Supplementary Video 1, Fig. 1B). Spontaneous right-beating nystagmus (peak slow-phase velocity, 10.4°/sec) lasted 104 seconds and gradually decreased. The nystagmus then changed direction to the left and lasted for 134 seconds (peak slow-phase velocity, 7.9°/sec) before reversing to the right again.
aPAN, which exhibits spontaneous alternating nystagmus without periodicity and regularity, is rarely seen in association with various peripheral and central vestibular disorders [1-3]. In lateral medullary stroke, aPAN may be caused by impairment of velocity storage and gaze holding [2].

Funding/Support

None.

Conflicts of Interest

Ji-Yun Park is the Editor-in-Chief of Research in Vestibular Science and was not involved in the review process of this article. All authors have no other conflicts of interest to declare.

Availability of Data and Materials

All data generated or analyzed during this study are included in this published article. For other data, these may be requested through the corresponding author.

Supplementary materials can be found via https://doi.org/10.21790/rvs.2024.010.

Supplementary Video 1.

Videooculography showed aperiodic alternating nystagmus with an irregular interval. Initially, spontaneous right-beating nystagmus (peak slow-phase velocity, 10.4°/sec) lasted 104 seconds and gradually decreased. The nystagmus then switched direction to the left and lasted for 134 seconds (peak slow-phase velocity, 7.9°/sec) before reversing back to the right again.
Fig. 1.
Brain magnetic resonance imaging demonstrated high signal intensity (arrow) in the left lateral medulla on the diffusion-weighted image (A). The plotting of the nystagmus reveals a spontaneous right-beating nystagmus (peak slow-phase velocity, 10.4°/sec) that reverses to left-beating nystagmus (peak slow-phase velocity, 7.9°/sec) and then reversing back to the right. A negative value indicates a rightward direction of the slow components of nystagmus (B).
rvs-2024-010f1.jpg
  • 1. Kim SH, Chung WK, Kim BG, Hwang CS, Kim MJ, Lee WS. Periodic alternating nystagmus of peripheral vestibular origin. Laryngoscope 2014;124:980–983.ArticlePubMed
  • 2. Kim SH, Kim JS. Aperiodic alternating nystagmus in lateral medullary strokes. Can J Neurol Sci 2019;46:486–488.ArticlePubMed
  • 3. Nuti D, Ciacci G, Giannini F, Rossi A, Federico A. Aperiodic alternating nystagmus: report of two cases and treatment by baclofen. Ital J Neurol Sci 1986;7:453–459.ArticlePubMedPDF

Figure & Data

References

    Citations

    Citations to this article as recorded by  

      • PubReader PubReader
      • ePub LinkePub Link
      • Cite
        CITE
        export Copy
        Close
        Download Citation
        Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
        Format:
        • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
        • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
        Include:
        • Citation for the content below
        Aperiodic alternating nystagmus in acute lateral medullary infarction: a video report
        Res Vestib Sci. 2024;23(2):61-62.   Published online June 14, 2024
        DOI: https://doi.org/10.21790/rvs.2024.010
        Close
      • XML DownloadXML Download
      Figure
      • 0
      Related articles
      Aperiodic alternating nystagmus in acute lateral medullary infarction: a video report
      Image
      Fig. 1. Brain magnetic resonance imaging demonstrated high signal intensity (arrow) in the left lateral medulla on the diffusion-weighted image (A). The plotting of the nystagmus reveals a spontaneous right-beating nystagmus (peak slow-phase velocity, 10.4°/sec) that reverses to left-beating nystagmus (peak slow-phase velocity, 7.9°/sec) and then reversing back to the right. A negative value indicates a rightward direction of the slow components of nystagmus (B).

      Fig. 1.

      Aperiodic alternating nystagmus in acute lateral medullary infarction: a video report
      Res Vestib Sci : Research in Vestibular Science
      © Korean Balance Society.
      TOP