Central nystagmus in progressive supranuclear palsy: A neglected clinical feature?
| Autor: | Milica G. Kramberger, Manja Hribar, Saba Battelino, Nina Zupancic, Nina Bozanic Urbancic, Maja Trošt, Maja Kojovic, Diego Kaski, Maja Klarendic |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty genetic structures Internuclear ophthalmoplegia Slovenia Postural instability Nystagmus Nystagmus Pathologic Progressive supranuclear palsy 03 medical and health sciences 0302 clinical medicine Atrophy Ophthalmology medicine Prevalence Humans Aged Aged 80 and over business.industry Parkinsonism Significant difference Eye movement Middle Aged medicine.disease eye diseases 030104 developmental biology Neurology Female Neurology (clinical) Supranuclear Palsy Progressive Geriatrics and Gerontology medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Parkinsonismrelated disorders. 84 |
| ISSN: | 1873-5126 |
| Popis: | Background Progressive supranuclear palsy (PSP) features parkinsonism characterized by early postural instability, falls and prominent eye movement abnormalities that consist of saccadic slowing, followed by gaze limitation. Nystagmus is not considered typical for PSP, being more commonly associated with multiple system atrophy. Objectives To describe the prevalence and phenomenology of nystagmus in patients with PSP. Methods 42 patients with probable PSP underwent detailed clinical eye movement examination. Patients with nystagmus performed video-nystagmography. T-test, Chi-Square test and Wilcoxon signed-rank test were used to test differences in demographic data, disease duration and PSP subtype between patients with and without nystagmus, and for analysis of video-nystagmographic data. Results Among 42 patients with PSP, we identified 15 patients (35,7%) with gaze-evoked nystagmus, predominantly horizontal. Clinically, 10/15 patients had symmetrical or asymmetrical gaze - evoked nystagmus (Type 1), while 5/15 patients had dissociated gaze-evoked nystagmus related to internuclear ophthalmoplegia (Type 2). Nystagmus and eye movement abnormalities were further characterized by video-nystagmography. There was no significant difference in age, disease duration or PSP subtypes between patients with and without nystagmus. Conclusion Central nystagmus is present in more than a third of patients with progressive supranuclear palsy. It may present as symmetrical or asymmetrical gaze-evoked nystagmus or as dissociated gaze-evoked nystagmus related to internuclear ophthalmoplegia and probably arises from neurodegeneration of the neural integrator. Nystagmus in PSP has been a hitherto under-described feature and its presence should not deter clinicians from a diagnosis of PSP. |
| Databáze: | OpenAIRE |
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