Abstract
A 29-year-old female had complained of unsteady gait for 6 years. Infection of the spinal cord was diagnosed. Traction of the lower limbs and tendonplasty of the Achilles tendon had been performed without improvement.
Unsteady gait was followed gradually by difficulty in speech, numbness below the mammary line, and weakness of the lower extremities. She could not stand without support. She was referred to the ENT department, because of dizziness and inability to follow moving objects visually.
ENG rerealed the following ocular motor abnormalities :
1. primary position upbeat nystagmus
2. rebound nystagmus
3. failure of fixation-suppression of caloric nystagmus
4. deranged pursuit eye movements
5. limitation of slow phase OKN velocity
These ENG findings suggested cerebellar and brainstem lesions. A CT scan through the posterior fossa showed brainstem atrophy with enlargement of the cistern of the midbrain and the pons. Signs of cerebellar atrophy were equivocal.
The neurological and neuroradiological findings led to a diagnosis of spinocerebellar degeneration.
The ENG test can be useful in the detection of central nervous system disorders.
