Τίτλος:
Square-Wave Ocular Oscillation and Ataxia in an Anti-GAD-Positive Individual with Hypothyroidism
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Cerebellar ataxia is an uncommon manifestation of hypothyroidism with unknown pathomechanism. The few descriptions of the clinical phenotype range from limb, gait, and trunk ataxia to various ocular motor abnormalities. We evaluated a 62-year-old woman with previously undetected severe hypothyroidism who presented with prominent saccadic intrusions and gait ataxia. She had high titers of antithyroid autoantibodies and anti-glutamic acid decarboxylase (anti-GAD) antibodies. Horizontal eye movement recordings revealed a series of nearly continuous pseudoharmonic square wave jerks (SWJs) constituting a square wave oscillation. Amplitudes reached maximum values of about 4, and wave frequency approached 100 cycles per minute. Thyroxine substitution and corticosteroid administration had little effect on SWJ parameters. The square wave oscillation nearly completely resolved after a single treatment session with intravenous immunoglobulin suggesting a causal link between an autoimmune process and the cerebellar dysfunction. Current concepts of the genesis of saccadic intrusions favor a role for anti-GAD antibodies in the etiology of SWJs. © 2015 by North American Neuro-Ophthalmology Society.
Συγγραφείς:
Brokalaki, C.
Kararizou, E.
Dimitrakopoulos, A.
Evdokimidis, I.
Anagnostou, E.
Περιοδικό:
Journal of Neuro-Ophthalmology
Εκδότης:
Lippincott Williams and Wilkins
Λέξεις-κλειδιά:
glutamate decarboxylase antibody; insulin; levothyroxine; methylprednisolone; autoantibody; glutamate decarboxylase, adult; Article; balance disorder; blood examination; case report; cerebellar ataxia; computer assisted tomography; diabetes control; diabetes mellitus; disease duration; drug withdrawal; dysarthria; dysphagia; esophagitis; eye movement; fatigue; female; gait disorder; hand movement; Hashimoto disease; hormone substitution; human; hypothyroidism; immunotherapy; medical history; middle aged; motor activity; nausea and vomiting; neuroimaging; nuclear magnetic resonance imaging; oscillation; oscillopsia; parameters; priority journal; speech disorder; square wave ocular oscillation; treatment duration; vertigo; biological rhythm; blood; cerebellar ataxia; complication; hypothyroidism; immunology; Ocular Motility Disorders; physiology, Autoantibodies; Biological Clocks; Cerebellar Ataxia; Female; Glutamate Decarboxylase; Humans; Hypothyroidism; Middle Aged; Ocular Motility Disorders
DOI:
10.1097/WNO.0000000000000275
