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Journal of Neuro-Ophthalmology:
doi: 10.1097/WNO.0000000000000123
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Downbeat Nystagmus Elicited by Eyelid Closure.

Lemos, João MD; Pereira, Daniela MD; Amorim, Margarida MD; Santiago, Beatriz MD; Paiva, António PhD; Cunha, Luís PhD

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We describe a patient with downbeat nystagmus (DBN) evoked only by eye closure. Brain and spinal cord magnetic resonance imaging revealed a T2 paramedian lesion in the left lower basis pontis and other white matter lesions consistent with multiple sclerosis. One potential mechanism for DBN in this case involves transverse ephaptic spread of excitation from areas that subserve coordinated lid closure to the decussating ventral tegmental tract.

(C) 2014 by North American Neuro-Ophthalmology Society