TY - JOUR T1 - Upbeat nystagmus in anti-Ma2 encephalitis JF - Practical Neurology JO - Pract Neurol SP - 36 LP - 38 DO - 10.1136/practneurol-2013-000524 VL - 14 IS - 1 AU - Pablo Garcia-Reitboeck AU - Graham Thompson AU - Paul Johns AU - Yasir Al Wahab AU - Salah Omer AU - Colette Griffin Y1 - 2014/02/01 UR - http://pn.bmj.com/content/14/1/36.abstract N2 - Anti-Ma2 encephalitis is a paraneoplastic disorder characterised by brainstem and/or limbic involvement. Eye movement abnormalities can occur in this condition, often with confusion or somnolence. We describe a patient with progressive oscillopsia (with upbeat nystagmus) and unsteadiness, followed by acute pancreatitis. She did not respond to immunomodulatory treatment and subsequently died of complications related to pancreatitis and sepsis. There was no tumour identified at autopsy, but the anti-Ma2 antibodies in her serum and the discovery of a brainstem-predominant inflammatory infiltrate at autopsy strongly suggest a paraneoplastic disorder. Our case illustrates that upbeat nystagmus can be a predominant feature in anti-Ma2 encephalitis; clinicians should consider testing for anti-Ma2 antibodies in patients with upbeat nystagmus of unknown cause. ER -