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Downbeat nystagmus
  1. Soumya Sharma1,
  2. Anu Gupta1,
  3. Aviraj Deshmukh1,
  4. Satbir Singh2,
  5. Vinod Puri1
  1. 1Department of Neurology, GIPMER, Jawaharlal Nehru Marg, New Delhi, India
  2. 2Department of Radiodiagnosis, GIPMER, New Delhi, India
  1. Correspondence to Dr Professor Vinod Puri, Department of Neurology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), Jawahar Lal Nehru Marg, New Delhi 110002, India; vpuri01{at}

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A 22-year-old man presented with progressive weakness and sensory loss in the left arm and leg for 1 year, imbalance while walking for 6 months, oscillopsia, dysphagia and urinary urgency for 3 months. Examination revealed a short neck, low posterior hairline and scoliosis. Downbeat nystagmus (DBN) was appreciated in the primary position of gaze. It increased in amplitude when the patient looked down and out, the so-called Daroff's sign1 (see online supplementary video). He also had lid nystagmus, right partial Horner's syndrome, lower cranial nerve palsies, bipyramidal …

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  • Contributors SoS and AD collected information and prepared the draft. AG, SaS and VP edited and reviewed the manuscript. All authors reviewed, edited and approved the final version.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.