Journal of Neurology

, Volume 265, Issue 5, pp 1219–1221 | Cite as

Hemi-seesaw nystagmus in a patient with acute infarction in the superior cerebellar artery territory

  • Hyung Lee
  • Hyun Ah Kim
Letter to the Editors

Dear Sirs,

Seesaw nystagmus refer to mixed torsional–vertical nystagmus with conjugate torsional components and the vertical components in the opposite directions [1]. While one eye moves upward and incyclorotates, the other eye moves downward and excyclorotates. During the next half cycle, the vertical and torsional movements reverse. Unlike with seesaw nystagmus, hemi-seesaw nystagmus is a jerky nystagmus, in which the slow phase corresponds to one half-cycle and the quick phase to the other [1]. Ocular tilt reaction is a sensitive clinical signs of a vestibular tone imbalance in the roll plane and consists of the triad of head tilt, ocular torsion and skew deviation, as well as tilts of the perceived subjective visual vertical. Hemi-seesaw nystagmus may be related to the ocular tilt reaction, which occurs due to interruption of the otolithic inputs from one labyrinth, running via the ipsilateral vestibular nuclei and contralateral medial longitudinal fasciculus to the region of the...


Author contributions

Dr. Kim conducted the design and conceptualization of the study, interpretation of the data, and revising the manuscript. Dr. Lee wrote the manuscript, and analyzed and interpreted the data.

Compliance with ethical standards

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest. Dr. Lee serves on the editorial boards of the Research in Vestibular Science, Frontiers in Neuro-otology, and Current Medical Imaging Review. Dr. Kim reports no disclosures.

Ethical standards

The patient involved gave consent for publication of the case.

Supplementary material

415_2018_8839_MOESM1_ESM.avi (21.9 mb)
The patient shows an extorsional downbeat nystagmus on the right eye and intorsional upbeat nystagmus on the left eye with horizontal component to the left side in the primary position. Videonystagmographic recording shows vertical eye movements. Note the patient also has a comitant hypertropia on the right eye (i.e., skew deviation) and head tilt to the left side. LV=vertical eye movement of the left eye; RV= vertical eye movement of the right eye (AVI 22405 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurologyKeimyung University School of MedicineDaeguRepublic of Korea
  2. 2.Brain Research InstituteKeimyung University School of MedicineDaeguRepublic of Korea

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