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Downbeat nystagmus

MedGen UID:
154401
Concept ID:
C0585544
Finding; Finding
Synonym: Nystagmus, downbeat
SNOMED CT: Downbeat nystagmus (307676006); Downbeat central nystagmus (307676006)
 
HPO: HP:0010545

Definition

Downbeat nystagmus is a type of fixation nystagmus with the fast phase beating in a downward direction. It generally increases when looking to the side and down and when lying prone. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVDownbeat nystagmus

Conditions with this feature

Episodic ataxia type 2
MedGen UID:
314039
Concept ID:
C1720416
Disease or Syndrome
Episodic ataxia is a genetically heterogeneous neurologic condition characterized by spells of incoordination and imbalance, often associated with progressive ataxia. Episodic ataxia type 2 is the most common form of EA (Jen et al., 2007). For a discussion of genetic heterogeneity of episodic ataxia, see EA1 (160120).
Autosomal recessive spinocerebellar ataxia 10
MedGen UID:
462348
Concept ID:
C3150998
Disease or Syndrome
Autosomal recessive spinocerebellar ataxia-10 is an autosomal recessive neurodegenerative disorder with onset in the teenage or young adult years of gait and limb ataxia, dysarthria, and nystagmus associated with marked cerebellar atrophy on brain imaging (summary by Vermeer et al., 2010). Some patients have low levels of coenzyme Q10 (CoQ10) in muscle and may show some clinical improvement with CoQ10 treatment (Balreira et al., 2014).
Cerebellar ataxia with neuropathy and bilateral vestibular areflexia syndrome
MedGen UID:
482853
Concept ID:
C3281223
Disease or Syndrome
Cerebellar ataxia, neuropathy, and vestibular areflexia syndrome (CANVAS) is an autosomal recessive adult-onset, slowly progressive neurologic disorder characterized by imbalance due to cerebellar gait and limb ataxia, impaired vestibular function bilaterally, and non-length-dependent sensory neuropathy (summary by Szmulewicz et al., 2011).
Spinocerebellar ataxia 45
MedGen UID:
1622156
Concept ID:
C4540400
Disease or Syndrome
A rare autosomal dominant cerebellar ataxia with characteristics of slowly progressive late-onset gait and limb ataxia, dysarthria and variable nystagmus. Brain imaging reveals cerebellar atrophy.
Spinocerebellar ataxia 27B, late-onset
MedGen UID:
1824051
Concept ID:
C5774278
Disease or Syndrome
Late-onset spinocerebellar ataxia-27B (SCA27B) is an autosomal dominant neurodegenerative disorder characterized by the onset of gait and appendicular ataxia in adulthood, usually around age 55 (range 30 to late eighties). About half of patients present with episodic features. The disorder is slowly progressive, and some patients may lose independent ambulation. Additional features include downbeat and horizontal nystagmus, diplopia, vertigo, and dysarthria. Brain imaging tends to show cerebellar atrophy (Pellerin et al., 2023). For a general discussion of autosomal dominant spinocerebellar ataxia, see SCA1 (164400).

Professional guidelines

PubMed

Tran TM, Lee MS, McClelland CM
Curr Opin Ophthalmol 2021 Nov 1;32(6):504-514. doi: 10.1097/ICU.0000000000000802. PMID: 34456290
Zwergal A, Feil K, Schniepp R, Strupp M
Semin Neurol 2020 Feb;40(1):87-96. Epub 2019 Dec 30 doi: 10.1055/s-0039-3400315. PMID: 31887755
Spiegel R, Rust H, Baumann T, Friedrich H, Sutter R, Göldlin M, Rosin C, Müri R, Mantokoudis G, Bingisser R, Strupp M, Kalla R
Swiss Med Wkly 2017;147:w14566. Epub 2017 Dec 27 doi: 10.4414/smw.2017.14566. PMID: 29282702

Recent clinical studies

Etiology

Lemos J, Manto M
Curr Opin Neurol 2022 Feb 1;35(1):118-125. doi: 10.1097/WCO.0000000000001015. PMID: 34845147
Lemos J, Strupp M
J Neurol 2022 Apr;269(4):1851-1860. Epub 2021 Oct 20 doi: 10.1007/s00415-021-10852-8. PMID: 34669008
Zwergal A, Feil K, Schniepp R, Strupp M
Semin Neurol 2020 Feb;40(1):87-96. Epub 2019 Dec 30 doi: 10.1055/s-0039-3400315. PMID: 31887755
Pinto WBVR, Debona R, Nunes PP, Assis ACD, Lopes CG, Bortholin T, Dias RB, Naylor FGM, Chieia MAT, Souza PVS, Oliveira ASB
Rev Neurol (Paris) 2019 Apr;175(4):221-232. Epub 2019 Mar 4 doi: 10.1016/j.neurol.2018.04.016. PMID: 30846210
Strupp M, Zwergal A, Feil K, Bremova T, Brandt T
Ann N Y Acad Sci 2015 Apr;1343:27-36. doi: 10.1111/nyas.12774. PMID: 25903394

Diagnosis

Lemos J, Strupp M
J Neurol 2022 Apr;269(4):1851-1860. Epub 2021 Oct 20 doi: 10.1007/s00415-021-10852-8. PMID: 34669008
Strupp ML, Straumann D, Helmchen C
Klin Monbl Augenheilkd 2021 Nov;238(11):1186-1195. Epub 2021 Nov 16 doi: 10.1055/a-1525-0030. PMID: 34784642
Tran TM, Lee MS, McClelland CM
Curr Opin Ophthalmol 2021 Nov 1;32(6):504-514. doi: 10.1097/ICU.0000000000000802. PMID: 34456290
Zwergal A, Feil K, Schniepp R, Strupp M
Semin Neurol 2020 Feb;40(1):87-96. Epub 2019 Dec 30 doi: 10.1055/s-0039-3400315. PMID: 31887755
Tarnutzer AA, Straumann D
Curr Opin Neurol 2018 Feb;31(1):74-80. doi: 10.1097/WCO.0000000000000517. PMID: 29120919

Therapy

Lemos J, Manto M
Curr Opin Neurol 2022 Feb 1;35(1):118-125. doi: 10.1097/WCO.0000000000001015. PMID: 34845147
Kalla R, Strupp M
Curr Neuropharmacol 2019;17(1):7-13. doi: 10.2174/1570159X16666180905093535. PMID: 30182858Free PMC Article
Strupp M, Zwergal A, Feil K, Bremova T, Brandt T
Ann N Y Acad Sci 2015 Apr;1343:27-36. doi: 10.1111/nyas.12774. PMID: 25903394
Strupp M, Zwergal A, Brandt T
Neurotherapeutics 2007 Apr;4(2):267-73. doi: 10.1016/j.nurt.2007.01.014. PMID: 17395137
Straube A
Curr Opin Neurol 2005 Feb;18(1):11-4. doi: 10.1097/00019052-200502000-00004. PMID: 15655396

Prognosis

Lemos J, Strupp M
J Neurol 2022 Apr;269(4):1851-1860. Epub 2021 Oct 20 doi: 10.1007/s00415-021-10852-8. PMID: 34669008
Kuwano A, Arai K, Aihara Y, Kawamata T
World Neurosurg 2020 Feb;134:577-579. Epub 2019 Nov 29 doi: 10.1016/j.wneu.2019.11.140. PMID: 31790839
Clark D, Eggenberger E
Curr Opin Ophthalmol 2012 Nov;23(6):491-6. doi: 10.1097/ICU.0b013e328358ba14. PMID: 23014265
Strupp M, Zwergal A, Brandt T
Neurotherapeutics 2007 Apr;4(2):267-73. doi: 10.1016/j.nurt.2007.01.014. PMID: 17395137
Slamovits TL, Gardner TA
Ophthalmology 1989 Apr;96(4):555-68. doi: 10.1016/s0161-6420(89)32877-6. PMID: 2657540

Clinical prediction guides

Méreaux JL, Davoine CS, Pellerin D, Coarelli G, Coutelier M, Ewenczyk C, Monin ML, Anheim M, Le Ber I, Thobois S, Gobert F, Guillot-Noël L, Forlani S, Jornea L, Heinzmann A, Sangare A, Gaymard B, Guyant-Maréchal L, Charles P, Marelli C, Honnorat J, Degos B, Tison F, Sangla S, Simonetta-Moreau M, Salachas F, Tchikviladzé M, Castelnovo G, Mochel F, Klebe S, Castrioto A, Fenu S, Méneret A, Bourdain F, Wandzel M, Roth V, Bonnet C, Riant F, Stevanin G, Noël S, Fauret-Amsellem AL, Bahlo M, Lockhart PJ, Brais B, Renaud M, Brice A, Durr A
EBioMedicine 2024 Jan;99:104931. Epub 2023 Dec 27 doi: 10.1016/j.ebiom.2023.104931. PMID: 38150853Free PMC Article
Lemos J, Manto M
Curr Opin Neurol 2022 Feb 1;35(1):118-125. doi: 10.1097/WCO.0000000000001015. PMID: 34845147
Lemos J, Strupp M
J Neurol 2022 Apr;269(4):1851-1860. Epub 2021 Oct 20 doi: 10.1007/s00415-021-10852-8. PMID: 34669008
Pinto WBVR, Debona R, Nunes PP, Assis ACD, Lopes CG, Bortholin T, Dias RB, Naylor FGM, Chieia MAT, Souza PVS, Oliveira ASB
Rev Neurol (Paris) 2019 Apr;175(4):221-232. Epub 2019 Mar 4 doi: 10.1016/j.neurol.2018.04.016. PMID: 30846210
Strupp M, Zwergal A, Feil K, Bremova T, Brandt T
Ann N Y Acad Sci 2015 Apr;1343:27-36. doi: 10.1111/nyas.12774. PMID: 25903394

Recent systematic reviews

Rowe FJ, Hanna K, Evans JR, Noonan CP, Garcia-Finana M, Dodridge CS, Howard C, Jarvis KA, MacDiarmid SL, Maan T, North L, Rodgers H
Cochrane Database Syst Rev 2018 Mar 5;3(3):CD011290. doi: 10.1002/14651858.CD011290.pub2. PMID: 29505103Free PMC Article

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