A Case of Infratentorial Meningioma Causing Spontaneous Downbeat Nystagmus: Case Report and Review of the Literature

World Neurosurg. 2020 Feb:134:577-579. doi: 10.1016/j.wneu.2019.11.140. Epub 2019 Nov 29.

Abstract

Background: Spontaneous downbeat nystagmus is a finding that raises suspicions of a central nervous system disorder. Vermis and lower brainstem lesions are considered to be responsible, but the exact mechanism is still controversial. We observed a rare case of spontaneous downbeat nystagmus caused by an infratentorial meningioma.

Case description: A 50-year-old woman was incidentally diagnosed with infratentorial tumor. Later, she suffered from oscillopsia and the symptom disturbed her daily life especially while driving. Magnetic resonance imaging showed a tumor of approximately 30 mm in diameter at the dorsal midline of the posterior fossa. The tumor was compressing the cerebellar vermis and was apparently responsible for the symptoms that affected her daily life; therefore, we decided to perform tumor removal. The postoperative course was uneventful, and the spontaneous downbeat nystagmus completely disappeared.

Conclusions: Vertical nystagmus is a finding that raises suspicion of a central nervous system disorder, and requires detailed examination. In addition, in case of vertical nystagmus because of tumor compression of the vermis, removal of the tumor can be an effective treatment.

Keywords: Downbeat nystagmus; Infratentorial meningioma; Vermian compression.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Brain / pathology
  • Female
  • Humans
  • Infratentorial Neoplasms / complications
  • Infratentorial Neoplasms / diagnosis
  • Infratentorial Neoplasms / surgery*
  • Magnetic Resonance Imaging / adverse effects
  • Meningeal Neoplasms / complications*
  • Meningeal Neoplasms / diagnosis
  • Meningeal Neoplasms / surgery*
  • Meningioma / complications*
  • Meningioma / diagnosis
  • Meningioma / surgery*
  • Middle Aged
  • Nystagmus, Pathologic / diagnosis
  • Nystagmus, Pathologic / etiology*
  • Nystagmus, Pathologic / surgery
  • Treatment Outcome