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Robert D. Yee, MD; Robert W. Baloh, MD; Vicente Honrubia, MD

Arch Ophthalmol. 1984;102(5):723-725.

Abstract
• A 36-year-old woman had intermittent downbeat nystagmus. Between episodes of downbeat nystagmus, eye movements were normal, except for stationary positional nystagmus and decreased vestibulo-ocular responses (VOR) to rotation. Smooth pursuit, optokinetic nystagmus, and visual-VOR interactions, which are usually impaired in patients with downbeat nystagmus and cerebellar dysfunction, were normal. Computed tomography and findings during a suboccipital craniotomy demonstrated a mild Chiari malformation, type 1. Episodic downbeat nystagmus that is not associated with other ocular motor abnormalities due to cerebellar dysfunction can be an initial sign of a Chiari malformation.

Author Affiliations
From the Jules Stein Eye Institute, Department of Ophthalmology (Dr Yee), the Department of Neurology (Dr Baloh), and the Division of Head and Neck Surgery (Dr Honrubia), UCLA School of Medicine.

Footnotes
Accepted for publication Sept 30, 1983.

Reprint requests to Jules Stein Eye Institute, 800 Westwood Plaza, Los Angeles, CA 90024 (Dr Yee).

This study was supported by grants EY03707 (Dr Yee) and EY04556 (Dr Baloh) from the National Eye Institute and by the Dolly Green Scholar Award (Dr Yee) from Research to Prevent Blindness, Inc, New York.

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