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Central positional nystagmus in inferior cerebellar peduncle lesions: a case series

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Abstract

We aimed to characterize the central positional nystagmus (CPN) observed in lesions involving the inferior cerebellar peduncle (ICP). We analyzed the clinical and neurotologic findings in six patients with an isolated unilateral ICP infarction that had been diagnosed at a university hospital in South Korea from 2003 to 2019. Patients usually presented with acute vestibular syndrome in isolation (4/6, 67%). Ipsilesional spontaneous nystagmus was observed in five while supine (5/6, 83%). Four (4/6, 67%) patients showed CPN which included apogeotropic (n = 3) or geotropic (n = 1) during head turning to either side while supine, and vertical nystagmus during straight-head hanging, Dix-Hallpike maneuvers, or up-righting (n = 3). Four patients showed contraversive ocular tilt reaction or tilt of the subjective visual vertical. Bedside and video head-impulse tests were normal in all patients. CPN is a usual finding in ICP lesions, and may be ascribed to damage of the fibers running from the nodulus/uvula onto the vestibular nucleus via the ICP.

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Funding

This study was supported by 2018 Academic Research Funds of the Korean Society of Clinical Neurophysiology, and Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (no. NRF-2016R1D1A1B04935568).

Author information

Authors and Affiliations

  1. Department of Neurology, Korea University Medical Center, Seoul, South Korea

    Sun-Uk Lee

  2. Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea

    Sun-Uk Lee, Jeong-Yoon Choi & Ji-Soo Kim

  3. Research Administration Team, Seoul National University Bundang Hospital, Seongnam, South Korea

    Hyo-Jung Kim

  4. Department of Neurology, Soonchunhyang University College of Medicine, Bucheon, South Korea

    Eek-Sung Lee

  5. Department of Neurology, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea

    Jae-Hwan Choi

  6. Dizziness Center, Clinical Neuroscience Center, and Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea

    Jeong-Yoon Choi & Ji-Soo Kim

Authors
  1. Sun-Uk Lee
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  2. Hyo-Jung Kim
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  3. Eek-Sung Lee
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  4. Jae-Hwan Choi
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  5. Jeong-Yoon Choi
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  6. Ji-Soo Kim
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Contributions

Dr. S.U. Lee analyzed and interpreted the data, and wrote the manuscript. Drs. H.J. Kim, I.S. Lee, J.Y. Choi, and J.H. Choi analyzed and interpreted the data, and revised the manuscript. Dr. J.S. Kim designed and conceptualized the study, interpreted the data, and revised the manuscript.

Corresponding author

Correspondence to Ji-Soo Kim.

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Conflict of interest

SU Lee, HJ Kim, IS Lee, JH Choi, and JY Choi report no disclosure. JS Kim serves as an Associate Editor of Frontiers in Neuro-otology and on the editorial boards of the Journal of Clinical Neurology, Frontiers in Neuro-ophthalmology, Journal of Neuro-ophthalmology, Journal of Vestibular Research, Journal of Neurology, and Medicine, and received research support from SK Chemicals, Co. Ltd.

Ethical standard

This study followed the tenets of the Declaration of Helsinki and was performed according to the guidelines of Institutional Review Board of Seoul National University Bundang Hospital (B-2009/634-103).

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Lee, SU., Kim, HJ., Lee, ES. et al. Central positional nystagmus in inferior cerebellar peduncle lesions: a case series. J Neurol 268, 2851–2857 (2021). https://doi.org/10.1007/s00415-021-10435-7

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  • DOI: https://doi.org/10.1007/s00415-021-10435-7

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