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Localizing Value

Isao Kato, MD; Tadashi Nakamura, MD; Jin Watanabe, MD; Koji Harada, MD; Masaru Aoyagi, MD; Tadashi Katagiri, MD

Arch Neurol. 1985;42(8):819-821.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Primary position upbeat nystagmus has been associated clinically with lesions of the midbrain,¹ cerebellar vermis,^2-5 brachium conjunctivum,⁶ and lower brain stem near the inferior olive.^7-9 However, only the latter two lesions have been confirmed pathologically.^6-8 Even in these studies, the precise localization remains unclear. We report a case of primary position upbeat nystagmus with a discrete vascular lesion that involved the hypoglossal nucleus and and adjacent structures.

REPORT OF A CASE

A 39-year-old woman was admitted seven days after a sudden onset of dysarthria and vertical oscillopsia. Results of an examination showed primary position upbeat nystagmus that persisted in all directions of gaze. No other oculomotor abnormalities were noticed. The tongue deviated to the right; fasciculation and slight atrophy were seen on the right side of the tongue with simultaneous palatal weakness (Fig 1). No other abnormal signs were observed.

Normal laboratory studies included complete . . . [Full Text PDF of this Article]

Author Affiliations
From the Departments of Otolaryngology (Drs Kato, Nakamura, Watanabe, Harada, and Aoyagi) and Neurology (Dr Katagiri), Yamagata University School of Medicine, Yamagata, Japan.

Footnotes
Accepted for publication March 22, 1984.

Reprint requests to Department of Otolaryngology, Yamagata University School of Medicine, 990-23 Yamagata, Japan (Dr Kato).

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