Case Reports in Neurology (Apr 2014)

Combined Ipsilateral Oculomotor Nerve Palsy and Contralateral Downbeat Nystagmus in a Case of Cerebral Infarction

  • Kosuke Matsuzono,
  • Yasuhiro Manabe,
  • Yoshiaki Takahashi,
  • Hisashi Narai,
  • Nobuhiko Omori,
  • Koji Abe

DOI
https://doi.org/10.1159/000362120
Journal volume & issue
Vol. 6, no. 1
pp. 134 – 138

Abstract

Read online

We report a patient with acute cerebral infarction of the left paramedian thalamus, upper mesencephalon and cerebellum who exhibited ipsilateral oculomotor nerve palsy and contralateral downbeat nystagmus. The site of the infarction was considered to be the paramedian thalamopeduncular and cerebellar regions, which are supplied by the superior cerebellar artery containing direct perforating branches or both the superior cerebellar artery and the superior mesencephalic and posterior thalamosubthalamic arteries. Contralateral and monocular downbeat nystagmus is very rare. Our case suggests that the present downbeat nystagmus was due to dysfunction of cerebellar-modulated crossed oculovestibular fibers of the superior cerebellar peduncle or bilateral downbeat nystagmus with one-sided oculomotor nerve palsy.

Keywords