Journal of Neurology

, Volume 259, Issue 2, pp 372–374 | Cite as

Vertical pendular nystagmus and hypertrophic inferior olivary nuclei degeneration: an “odd couple”

  • Antonio CarotaEmail author
  • Norbert Düron
  • Carlo Cereda
  • Claudio L. Bassetti
Letter to the Editors

Dear Sirs,

A 56-year-old man had a hypertensive pontine hemorrhage (Fig.  1a), which resulted in bilateral internuclear ophthalmoplegia, pseudobulbar palsy, and spastic ataxic tetraparesis. Three months after a stroke, while neurological deficits were recovering, the patient manifested progressively blurred vision and oscillopsia, corresponding to a vertical conjugate pendular nystagmus (PN) (video). Electronystagmography showed a 3-Hz frequency and 2–3° amplitude sinusoidal curve, with up- and down-phases symmetric for direction and velocity, without null zones and torsional or gaze-evoked components. PN was not modified by eye covering, saccades, head thrust, 20 diopter prisms, optokinetic maneuvers, and sleep.


Lamotrigine Memantine Pregabalin Inferior Olive Diopter Prism 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest

The authors declare that they have no conflicts of interests and that they have no grants to disclose for this study. The manuscript has not been published elsewhere and has not been submitted simultaneously for publication to another source. There is no ghost writing by anyone not named on the author list.

Supplementary material

Video Legend The patient shows a pure vertical conjugate 2-3 Hz, 2-3° amplitude pendular nystagmus (PN). Up- and down-phases are symmetric for direction and velocity and without null zones. There are no torsional or gaze-evoked components. The video shows that PN is not modified by poursuit and saccadic eye movement, convergence, or active or passive head thrust (tilt and slow rotation) (MPG 54722 kb)


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Antonio Carota
    • 1
    Email author
  • Norbert Düron
    • 1
  • Carlo Cereda
    • 2
  • Claudio L. Bassetti
    • 2
  1. 1.Hildebrand Clinic Rehabilitation Center BrissagoBrissagoSwitzerland
  2. 2.Department of Neurology, NeurocenterCivic HospitalLuganoSwitzerland

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