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Oscillopsia and nystagmus began in a woman 2 weeks after an inadvertent lumbar puncture during anesthesia for childbirth.Examination showed horizontal-torsional jerk nystagmus in all positions of gaze.Magnetic- search-coil oculography revealed accelerating slow phases,with an increase in nystagmus amplitude in darkness.Magnetic resonance images showed type 1 Arnold-Chiari malformation.Three months after occipital decompressive surgery,nystagmus had almost disappeared.Accelerating slow phases should not be considered diagnostic of congenital nystagmus,especially with an onset of oscillopsia in adult life;imaging should be considered to exclude treatable hindbrain anomalies.Lumbar puncture in patients with the Arnold- Chiari malformation may accentuate craniospinal pressure dissociation and precipitate neurological signs. |
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