Abstract
BackgroundIn Patients with spinocerebellar ataxia type 6 (SCA6) are often treated by transcranial magnetic stimulation (TMS) over the motor cortex and cerebellum. However, few reports have examined effective therapeutic modalities for diplopia in SCA6 patients. In the current case, we applied single-pulse TMS over the motor cortex and cerebellum to improve ataxia, and observed an unexpected improvement of diplopia.Case presentationA 62-year-old Japanese male with spinocerebellar ataxia type 6 (SCA6) was admitted to our hospital for exacerbation of ataxia. We administered single-pulse transcranial magnetic stimulation (TMS) over the hand motor area and the cerebellum with a circular coil to reduce ataxia. After the initiation of TMS, since diplopia unexpectedly improved, we started a quantitative assessment of diplopia by counting the number of fixation spots that he observed in his visual field. This assessment suggested that TMS had an immediate and cumulative effect on diplopia. We also delivered more localized stimulation only over the motor cortex with a Figure-8 coil, and diplopia improved immediately. Additionally, we administered a sham stimulation before the real stimulation over the motor cortex and the cerebellum. The sham stimulation improved diplopia, and greater improvement was observed with subsequent real stimulation. We also used a Hess chart examination and video recordings of binocular gross appearance to elucidate the changes in ocular movement objectively. However, these examinations did not reveal any obvious oculomotor changes.ConclusionsWe applied single-pulse TMS to a SCA6 patient with diplopia, which improved without any adverse effects. TMS may have potential for the treatment of diplopia in SCA6 patients.
Highlights
Spinocerebellar ataxia type 6 (SCA6) is an autosomal dominant neurodegenerative disease that is characterized by progressive symptoms such as ataxia, pyramidal and extrapyramidal disorder, dysphagia, sensory disturbances and oculomotor disorders including diplopia [1,2,3].spinocerebellar ataxia type 6 (SCA6) patients are often treated by transcranial magnetic stimulation (TMS) over the motor cortex and cerebellum [4,5,6]
We applied single-pulse TMS to a SCA6 patient with diplopia, which improved without any adverse effects
SCA6 patients are often treated by transcranial magnetic stimulation (TMS) over the motor cortex and cerebellum [4,5,6]
Summary
We applied single-pulse TMS to a SCA6 patient with diplopia, which improved without any adverse effects.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
