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6 1) Bender MB, Gorman WF : Vertical nystag mus on direct forward gaze with vertical oscillopsia. Am J Ophthalmol 32 : , ) Hozawa J, Fujiwara F, Saito H, et al : The value of "trapezoid rotation test" by Contra ves computerized rotary chair system. Acta Otolaryngol (Stockh) Suppl 435 : 55-63, ) Ichijo H, Hozawa J, Fujiwara F, et al : Comparative study of computerized trape zoid rotation test and sinusoidal harmonic acceleration test. Acta Otolaryngol (Stockh) Suppl 481 : , ) Leigh RJ, Zee DS : The neurology of eye movements. Edition 2. pp , FA Davis Company, Philadelphia, ) Baloh RW, Spooner JW : Downbeat nystag- Equilibrium Res Vol. 51(4) (478)
7 mus : A type of central vestibular nystag mus. Neurol (Ny) 31 : , ) Halmagyi GM, Rudge P, Gresty MA, et al : Downbeating nystagmus : A review of 62 cases. Arch Neurol 40 : , ) Cox TA, Corbett JJ, Thompson HS, et al : Upbeat nystagmus changing to downbeat nystagmus with convergence. Neurol (Ny) 31 : , ) Gilman N, Baloh RW and Tomiyasu U Primary position upbeat nystagmus : A cli nicopathologic study. Neurol (Ny) 27 : , ) Troost BT, Martinez J, Abel LA, et al : Up beat nystagmus and internuclear ophthal moplegia with brainstem glioma. Arch Neu rol 37 : , ) Cogan DG, Barrows LJ : Platybasia and the Arnold-Chiari malformation. Arch Oph talmol 52 : 13-29, 1954 mechanism of downbeat nystagmus. Arch Neurol 30 : , ) Daroff RB, Troost BT : Upbeat nystagmus (Letter to editor). JAMA 225 : 312, 1973 Abstract A careful analysis was made of the results of electronystagmography in 3 patients with spon taneous vertical nystagmus, and the causes of their nystagmus are discussed. Case 1 : a 24-year-old man showed primary position upbeat nystagmus with large amplitude (4-6 ) and 2 Hz frequency, which decreased on upward gaze and increased on downward gaze. This nystagmus changed to downbeat nystagmus when convergent gaze was maintained. Marked bilateral diminution of vestibular re sponse was noted during rotation tests and ca loric tests. Case 2 : an 80-year-old man had primary po sition downbeat nystagmus at a frequency of 1.5Hz and an amplitude of 2-4, which was not 14) Zee DS, Yamazaki A, Butler PH, et al : Ef fects of ablation of flocculus and parafloc culus on eye movements in primate. J Neu rophvsiol 46 : , ) Hirose G, Kawada J, Tsukada K, et al : Primary position upbeat nystagmus-clinicopathologic study of four patients. Acta Oto laryngol (Stockh) Suppl 481 : , ) Zee DS, Friendlich AR, Robinson DA : The influenced by changes of eye position. Vertical optokinetic nystagmus tests were abnormal, but other neuro-otological findings were almost normal. Case 3 : a 47-year-old woman showed primary position downbeat nystagmus with small am plitude (1-2 ) and 3 Hz frequency, which in- creased in intensity in the supine right-sidedown position and changed to an upward vector in the head-hanging-position. VOR gain was greater than normal. There was almost total absence of visual suppression of caloric nystag mus. The nystagmus observed in Case 1 seemed to reflect bilateral dysfunction of the caudal brainstem, including both vestibular nuclei, resulting from Wernicke's encephalopathy. The nystag mus in Case 3 originated from caudal brainstem compression by a large menigioma. In Case 2, no diagnosis was established. (479) Equilibrium Res Vol. 51(4)
8 Key words : primary position upbeat nystagmus, primary position downbeat nystag mus, electronystagmography, cau dal brainstem
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vestibulo-ocular reflex: VOR optokinetic nystagmus: OKN Vestibulo-optokinetic interaction: VOI) unilateral peripheral vestibular disfunction: UPVD VOI UPVD canal paresis: CP % VOR VOR OKN electro-oculography:
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