Francesco Comacchio*, Vera Markova, Daria Accordi, Francesca Covizzi and Paola Magnavita
Abstract: Primary spontaneous down-beat nystagmus (PDBN) is characterized by slow upward ocular drifts and fast downward phases, and is the most common form of acquired ocular movements overcoming fixation. PDBN is essentially due to lesions at the cranio-cervical junction, or diseases of the lower brainstem and cerebellum. Intoxication due to lithium or anti-epileptic drugs, abuse of toluene, and metabolic disturbances such vitamin B1, B12 deficiency, have also been reported. Hypomagnesemia has rarely been reported as another possible cause of PDBN. We report here a case of reversible high-intensity PDBN, due to severe hypomagnesaemia with ataxia, objective vertigo and oscillopsia, although initial cerebellar MR imaging was normal. Monitoring of nystagmus according to magnesemia is reported and discussed.
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