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KMID : 1036520160060010001
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Clinical Neuro-Ophthalmology
2016 Volume.6 No. 1 p.1 ~ p.4
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Pathophysiology of Vertical Nystagmus
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Kang Bong-Hui
Kim Jae-Il
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Abstract
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According to the experimental data and the three main clinical focal causes of spontaneous vertical nystagmus - upbeat nystagmus in the pons or caudal medulla lesions and downbeat nustagmus in the cerebellar flocculus and/or paraflocculus lesions, it is hypothesized that the excitatory superior vestibular nucleus - ventral tegmental tract pathway, along with its specific floccular inhibition, has developed to counteract the gravity pull. Although there have been a few reports of downbeat nystagmus caused by lesions in the midline region of the lower brainstem, it is suspected that lesions in the paramedian tract cells might be responsible for vertical vestibular imbalance, forming a cerebellum-brainstem feedback loop. The pathophysiology of spontaneous upbeat and downbeat nystagmus is reviewed in the light of several instructive clinical findings and experimental data herein.
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KEYWORD
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Vertical nystagmus, Downbeat nystagmus, Upbeat nystagmus
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