Ocular Bobbing in Brain Metastasis

  • An-Guor Wang


A 47-year-old female presented with complaints of eye pain OU. She was bedridden and very weak and had a significant history of breast cancer with brain metastasis. Ophthalmic consultation showed that there was lagophthalmos in both eyes. Her visual acuity was unable to be assessed due to her poor general condition. There were mild cataracts in both lenses. Her eyeballs were soft by digital examination. A Hirschberg test showed a mild degree of esotropia. Extraocular movements showed ocular bobbing on primary gaze, with severe limitation of horizontal gaze (Fig. 39.1, Video 39.1). MR imaging revealed multiple lesions in the bilateral cerebral hemispheres and cerebellar hemispheres, with an enhancing metastatic lesion over the dorsal pontine region (Fig. 39.2). She received whole brain radiotherapy and chemotherapy and was then discharged with stable conditions. She was lost to follow-up 4 months later.

Supplementary material

Video 39.1

(MOV 30052 kb)


  1. 1.
    Mehler MF. The clinical spectrum of ocular bobbing and ocular dipping. J Neurol Neurosurg Psychiatry. 1988;51(5):725–7.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Zegers de Beyl D, Flament-Durand J, Borenstein S, Brunko E. Ocular bobbing and myoclonus in central pontine myelinolysis. J Neurol Neurosurg Psychiatry. 1983;46:564–5.CrossRefGoogle Scholar
  3. 3.
    Katz B, Hoyt WF, Townshend J. Ocular bobbing and unilateral pontine hemorrhage: report of a case. J Clin Neuroophthalmol. 1982;2:193–5.PubMedGoogle Scholar
  4. 4.
    Finelli PF, McEntee WJ. Ocular bobbing with extra-axial haematoma of posterior fossa. J Neurol Neurosurg Psychiatry. 1977;40:386–8.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Rudick R, Satran R, Eskin TA. Ocular bobbing in encephalitis. J Neurol Neurosurg Psychiatry. 1981;44:441–3.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Drake ME Jr, Erwin CW, Massey EW. Ocular bobbing in metabolic encephalopathy: clinical, pathologic, and electrophysiologic study. Neurology. 1982;32:1029–31.CrossRefPubMedGoogle Scholar
  7. 7.
    Fisher CM. Ocular bobbing. Arch Neurol. 1964;11:543–6.CrossRefPubMedGoogle Scholar
  8. 8.
    Daroff RB, Troost BT, Dell’Osso LF. Nystagmus and related ocular oscillations. In: Glaser JS, editor. Neuro-ophihalmology. Hagerstown: Harper and Row; 1978. p. 219–40.Google Scholar
  9. 9.
    Stark SR, Masucci EF, Kurtzke JF. Ocular dipping. Neurology. 1984;34:391–3.CrossRefPubMedGoogle Scholar
  10. 10.
    Wong AME. Eye movement disorders. Oxford: Oxford University Press; 2008. p. 130–1.Google Scholar
  11. 11.
    Knobler RL, Somasundaram M, Schutta HS. Inverse ocular bobbing. Ann Neurol. 1981;9:194–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Susac JO, Hoyt WF, Daroff RB, Lawrence W. Clinical spectrum of ocular bobbing. J Neurol Neurosurg Psychiatry. 1970;33:771–5.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • An-Guor Wang
    • 1
  1. 1.Department of OphthalmologyTaipei Veterans General Hospital, National Yang-Ming University School of Medicine, Yun-San Ophthalmology Education Research FoundationTaipeiTaiwan

Personalised recommendations