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NEUROLOGY 2004;62:663-665
© 2004 American Academy of Neurology
Brief Communications

Bowtie and upbeat nystagmus evolving into hemi-seesaw nystagmus in medial medullary infarction

Possible anatomic mechanisms

K. -D. Choi, MD, D. S. Jung, MD PhD, K. -P. Park, MD, J. -W. Jo, MD and J. S. Kim, MD PhD

From the Department of Neurology (Drs. Choi, Jung, Park, and Jo), School of Medicine, Pusan National University; and Department of Neurology (Dr. Kim), College of Medicine, Seoul National University, Korea.

Address correspondence and reprint requests to Dr. Ji Soo Kim, Department of Neurology, College of Medicine, Seoul National University, Department of Neurology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea; e-mail: jisookim{at}snu.ac.kr

A 20-year-old man with bilateral medial medullary infarction showed transition of bowtie and upbeat nystagmus into hemi-seesaw nystagmus. Follow-up MRI revealed near complete resolution of the right medullary lesion. This transition of nystagmus suggests that the upbeat nystagmus was generated by bilateral lesions in the ascending pathways from both anterior semicircular canals (SCC), and that the hemi-seesaw nystagmus was caused by damage to the pathway from the left anterior SCC.

Received August 5, 2003. Accepted in final form October 19, 2003.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the February 24 issue to find the title link for this article.




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