Possible Causes for ocular bobbing Intrapontine Hemorrhage Spontaneous downward eye movements - ocular bobbing - imply preservation of rostral brainstem gaze centres. smaller unilateral basal pontine lesions show contralateral hemiparesis [gpnotebook.co.uk] Contralateral hemiparesis, contralateral conjugate gaze paresis, or confusion Brain stem - Tetraparesis, facial weakness, decreased level of consciousness, gaze paresis, ocular [en.wikipedia.org] bobbing, miosis, or autonomic instability Cerebellum - Ataxia, usually beginning in the trunk, ipsilateral facial weakness, ipsilateral sensory loss, gaze paresis, skew deviation [en.wikipedia.org] Central Pontine Myelinolysis Ocular bobbing and myoclonus in central pontine myelinolysis. [ncbi.nlm.nih.gov] Pontine Glioma A 36-year-old male was admitted with a 10-year history of gradually progressive left ear hearing loss, diplopia and right hemiparesis. Magnetic resonance imaging showed a left lateral pontine enhancing tumour and an additional cerebellopontine angle epidermoid tumour in close proximity forming a collision tumour. On[…] [ncbi.nlm.nih.gov] Malignant Glioma Int J Mol Sci. 2017 Feb 10;18(2). pii: E350. doi: 10.3390/ijms18020350. Author information 1 Institute of Life Sciences, Chongqing Medical University, 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China. yingying_shao1226@outlook.com. 2 Department of Clinical Pharmacology, Xiangya Hospital, Central South University,[…] [ncbi.nlm.nih.gov] Metabolic Encephalopathy A patient with atypical ocular bobbing resulting from metabolic encephalopathy is described. [ncbi.nlm.nih.gov] Neurologic examination showed no signs of brainstem dysfunction, and postmortem examination failed to disclose any changes in sites associated with ocular bobbing in other [ncbi.nlm.nih.gov] This is the first demonstration of functional disturbance in brainstem loci that are thought to be responsible for the infrequently observed ocular bobbing in metabolic encephalopathy [ncbi.nlm.nih.gov] Phenothiazine Poisoning Reverse ocular bobbing due to combined phenothiazine and benzodiazepine poisoning. Statistics from Altmetric.com This is a PDF-only article. [jnnp.bmj.com] Basilar Artery Thrombosis Ocular bobbing. Arch Neurol. 1970 Apr. 22(4):348-56. [Medline]. Nenci GG, Gresele P, Taramelli M, et al. [emedicine.medscape.com] Ocular Bobbing. Arch Neurol. 1964 Nov. 11:543-6. [Medline]. Fisher CM. Atherosclerosis of the carotid and vertebral arteries: extracranial and intracranial. [emedicine.medscape.com] bobbing, which localizes the lesion to the pons - This is characterized by a brisk, downward movement of the eyeball with a subsequent return to the primary position. [emedicine.medscape.com] Malnutrition bobbing. [ncbi.nlm.nih.gov] Ocular bobbing is more irregular than nystagmus and usually occurs in locked-in syndrome. Questions To access free multiple choice questions on this topic, click here. [ncbi.nlm.nih.gov] […] medication side effect, hyperventilation, or even alcohol or drug toxicity.[7][8][9][10][11] The differential diagnosis of nystagmus also includes oculogyric crises and ocular [ncbi.nlm.nih.gov] Basilar Artery Thrombosis with Occlusion of a Precerebral Artery Ocular bobbing. Arch Neurol. 1970 Apr. 22(4):348-56. [Medline]. Nenci GG, Gresele P, Taramelli M, et al. [emedicine.medscape.com] Ocular Bobbing. Arch Neurol. 1964 Nov. 11:543-6. [Medline]. Fisher CM. Atherosclerosis of the carotid and vertebral arteries: extracranial and intracranial. [emedicine.medscape.com] Vertebrobasilar Insufficiency bobbing Vertical gaze palsy (CN lll lesion) Horizontal gaze palsy (CN 6 lesion Facial nerve paralysis Bulbar palsy ( dysarthria, dysphonia, dysphagia, dysarthria, facial [ncbi.nlm.nih.gov] […] and can include the following: Change in level of consciousness Hemiparesis Alteration in pupil size and reactivity Cranial nerve palsies (usually abducens nerve palsy) Ocular [ncbi.nlm.nih.gov] Posterior Inferior Cerebellar Artery Occlusion Ocular bobbing is a less constant feature. [tchain.com] Ocular bobbing. Midbrain syndromes: Vertical gaze palsy. Third cranial nerve palsy. Pontine syndromes: Tremor, ataxia and mild hemiparesis. Horizontal gaze palsy. [patient.info] Locked-in Syndrome Locked-in syndrome together with an ocular bobbing phenomenon was observed in a 41-year-old man, an association which has not been reported earlier. [ncbi.nlm.nih.gov] The patient had ocular bobbing. [ncbi.nlm.nih.gov] M.: Ocular bobbing. Arch. Neurol. (Chic.) 11, 543–546 (1964) Google Scholar 24. French, J. D., Magoun, H. [doi.org] Posterior Cerebral Artery Occlusion with Infarction Ocular bobbing. Midbrain syndromes: Vertical gaze palsy. Third cranial nerve palsy. Pontine syndromes: Tremor, ataxia and mild hemiparesis. Horizontal gaze palsy. [patient.info] bobbing may be present. [neupsykey.com] […] the dorsal portion (tegmentum) of the pons produces unilateral or bilateral abducens (VI) nerve palsy; horizontal eye movements are impaired, but vertical nystagmus and ocular [neupsykey.com] Disorder of Basilar Artery Ocular bobbing. Arch Neurol. 1970 Apr. 22(4):348-56. [Medline]. Nenci GG, Gresele P, Taramelli M, et al. [emedicine.medscape.com] Ocular bobbing. Midbrain syndromes: Vertical gaze palsy. Third cranial nerve palsy. Pontine syndromes: Tremor, ataxia and mild hemiparesis. Horizontal gaze palsy. [patient.info] Ocular bobbing is a less constant feature. [dizziness-and-balance.com] Brain Stem Infarction Ocular bobbing is a less constant feature. [tchain.com] Posterior Cerebral Artery Thrombosis Ocular bobbing. Midbrain syndromes: Vertical gaze palsy. Third cranial nerve palsy. Pontine syndromes: Tremor, ataxia and mild hemiparesis. Horizontal gaze palsy. [patient.info] Ocular bobbing. Arch Neurol. 1970 Apr. 22(4):348-56. [Medline]. Nenci GG, Gresele P, Taramelli M, et al. [emedicine.medscape.com] bobbing may be present. [neupsykey.com] Internal Auditory Artery Occlusion bobbing, which localizes the lesion to the pons: This is characterized by a brisk downward movement of the eyeball with a subsequent return to the primary position. [learn.jobisite.com] Ocular bobbing is a less constant feature. [dizziness-and-balance.com] […] simultaneously affecting the paramedian reticular formation and the medial longitudinal fasciculus, resulting in ipsilateral conjugate gaze palsy and internuclear ophthalmoplegia Ocular [learn.jobisite.com] Obstructive Sleep Apnea bobbing. [ncbi.nlm.nih.gov] Ocular bobbing is more irregular than nystagmus and usually occurs in locked-in syndrome. Questions To access free multiple choice questions on this topic, click here. [ncbi.nlm.nih.gov] […] medication side effect, hyperventilation, or even alcohol or drug toxicity.[7][8][9][10][11] The differential diagnosis of nystagmus also includes oculogyric crises and ocular [ncbi.nlm.nih.gov] Diazinon Poisoning Atypical ocular bobbing in acute organophosphate poisoning. Arch Neurol 1986 ; 43 : 185 –6. Wadia RS, Sadagopan C, Amin RB, et al. [jnnp.bmj.com] Brain Stem Disorder Ocular bobbing is a less constant feature. [tchain.com] Cerebellar Stroke Ocular bobbing is a less constant feature. [dizziness-and-balance.com] Neonatal Intracranial Hemorrhage Clinical findings included multiple ecchymoses, gastric hemorrhage, hematuria, a tense fontanelle, head circumference at the 95th percentile, hypotonia, and ocular bobbing [pediatricneurologybriefs.com] Intracerebral Hematoma Contralateral hemiparesis, contralateral conjugate gaze paresis, or confusion Brain stem - Tetraparesis, facial weakness, decreased level of consciousness, gaze paresis, ocular [en.wikipedia.org] Other less frequent ocular signs include blepharospasm, involuntary closure of one eye, ocular bobbing, & skew deviation. [enotes.tripod.com] In addition to its “classic” syndrome characterized by coma, quadriplegia, ocular fixation, absence of light reaction, pinpoint pupil (about 1mm in diameter) ocular bobbing [ispub.com] Posterior Cerebral Artery Occlusion Ocular bobbing. Midbrain syndromes: Vertical gaze palsy. Third cranial nerve palsy. Pontine syndromes: Tremor, ataxia and mild hemiparesis. Horizontal gaze palsy. [patient.info] Vertebral Artery Thrombosis Ocular bobbing. Midbrain syndromes: Vertical gaze palsy. Third cranial nerve palsy. Pontine syndromes: Tremor, ataxia and mild hemiparesis. Horizontal gaze palsy. [patient.info] Ocular bobbing is a less constant feature. [dizziness-and-balance.com] Ocular bobbing is described as a brisk, downward movement of the eyeball with a subsequent return to the primary position. This deficit localizes the lesion to the pons. [emedicine.medscape.com] Basal Ganglia Hemorrhage Contralateral hemiparesis, contralateral conjugate gaze paresis, or confusion Brain stem - Tetraparesis, facial weakness, decreased level of consciousness, gaze paresis, ocular [en.wikipedia.org] bobbing, miosis, or autonomic instability Cerebellum - Ataxia, usually beginning in the trunk, ipsilateral facial weakness, ipsilateral sensory loss, gaze paresis, skew deviation [en.wikipedia.org] Reversible Ischemic Neurologic Deficit – May cause internuclear ophthalmoplegia, conjugate horizontal gaze palsy, or ocular bobbing. Ptosis and nystagmus are common but variable. [demosmedical.com] Intracranial Hemorrhage Contralateral hemiparesis, contralateral conjugate gaze paresis, or confusion Brain stem - Tetraparesis, facial weakness, decreased level of consciousness, gaze paresis, ocular [en.wikipedia.org] bobbing, miosis, or autonomic instability Cerebellum - Ataxia, usually beginning in the trunk, ipsilateral facial weakness, ipsilateral sensory loss, gaze paresis, skew deviation [en.wikipedia.org] Brain Stem Hemorrhage Ocular bobbing is a less constant feature. [dizziness-and-balance.com] Eye Muscle Disorder Ocular bobbing consists of rhythmic downward jerks of the eyes followed by a slow return to the midposition. [jnnp.bmj.com] Isolated ocular flutter might be seen in 8% of the population (voluntary flutter induced by convergence—incorrectly termed voluntary nystagmus), but may also be seen in multiple [jnnp.bmj.com]
