Dr.Madhu Karna, Dr.Satya Karna
The first instinct on noticing abnormal head posture with nystagmus is to operate and correct the AHP. Not uncommonly, one may observe an opposite head posture mistaking it for an overcorrection. Here we present a video signifying the importance of diligent observation along with knowledge of periodic alternating nystagmus. Acquired Periodic Alternating nystagmus (PAN) is a horizontal jerk nystagmus with slow phase nystagmus changing direction at regular intervals associated with cerebellar disorders and treated with Baclofen and Memantine. However, aperiodic asymmetric PAN, which follows Alexander’s law, has alternating head postures and irregular intervals between changing direction of nystagmus. It would be discussed with its presenting signs, associations and surgical management.


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