Guy J R, Schatz N J
Department of Ophthalmology, University of Florida School of Medicine, Gainesville 32610.
J Clin Neuroophthalmol. 1988 Dec;8(4):269-72.
We report a case of primary position downbeating nystagmus due to an occult breast carcinoma in a 57-year-old woman with progressive oscillopsia and truncal ataxia. Acute nausea and vomiting precipitated hospitalization. Magnetic resonance imaging of the brain was normal, though a sterile mononuclear cerebrospinal fluid pleocytosis was present. Search for an occult malignancy disclosed an adenocarcinoma of the breast. Radical mastectomy and oral corticosteroid therapy did not alter the clinical course of the paraneoplastic syndrome in our patient. Primary position downbeating nystagmus is an uncommon manifestation of an occult malignancy. Our report and review of the literature suggests that investigations necessary for the diagnosis of occult malignancies of the lung, breast, uterus, and ovary be included in the search for cryptic causes of downbeating nystagmus.
我们报告了一例57岁女性因隐匿性乳腺癌导致的原眼位下跳性眼球震颤病例，该患者伴有进行性视振荡和躯干共济失调。急性恶心和呕吐促使其住院治疗。脑部磁共振成像正常，但脑脊液中存在无菌性单核细胞增多。对隐匿性恶性肿瘤的检查发现了乳腺癌。根治性乳房切除术和口服皮质类固醇治疗并未改变我们患者副肿瘤综合征的临床病程。原眼位下跳性眼球震颤是隐匿性恶性肿瘤的一种罕见表现。我们的报告及文献回顾表明，在寻找下跳性眼球震颤的隐匿病因时，应包括对肺、乳腺、子宫和卵巢隐匿性恶性肿瘤诊断所需的检查。
