Periodic alternating nystagmus in a patient with MS
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Periodic alternating nystagmus (PAN) is a rare horizontal nystagmus that periodically reverses its direction, usually about every 2 minutes.1 Acquired PAN has been reported in various neurologic disorders, such as spinocerebellar ataxia, Arnold–Chiari malformation,1-3⇓⇓ and MS.4 We report a case of MS with PAN demonstrated by electronystagmography (ENG).
Case report.
A 39-year-old woman is presented. At age 27, she had a left optic neuritis. At age 31, she developed a moderate right limb and truncal ataxia and ataxic dysarthria with mild left hemiparesis. MRI detected multiple lesions in the right middle cerebellar peduncle, right lateral midpons, and right ventral midbrain. She was diagnosed as having MS, improved with corticosteroid treatment, and continued to take low-dose prednisolone thereafter. At age 39, she again developed a moderate truncal and, at this time, left limb ataxia, as well as an ataxic dysarthria. About 3 months later, she had a left visual loss and exacerbation of cerebellar ataxia, and was admitted to our hospital.
On admission, blindness …
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