Central positional nystagmus in inferior cerebellar peduncle lesions: a case series

Sun Uk Lee, Hyo Jung Kim, Eek Sung Lee, Jae Hwan Choi, Jeong Yoon Choi, Ji Soo Kim

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2 Scopus citations


We aimed to characterize the central positional nystagmus (CPN) observed in lesions involving the inferior cerebellar peduncle (ICP). We analyzed the clinical and neurotologic findings in six patients with an isolated unilateral ICP infarction that had been diagnosed at a university hospital in South Korea from 2003 to 2019. Patients usually presented with acute vestibular syndrome in isolation (4/6, 67%). Ipsilesional spontaneous nystagmus was observed in five while supine (5/6, 83%). Four (4/6, 67%) patients showed CPN which included apogeotropic (n = 3) or geotropic (n = 1) during head turning to either side while supine, and vertical nystagmus during straight-head hanging, Dix-Hallpike maneuvers, or up-righting (n = 3). Four patients showed contraversive ocular tilt reaction or tilt of the subjective visual vertical. Bedside and video head-impulse tests were normal in all patients. CPN is a usual finding in ICP lesions, and may be ascribed to damage of the fibers running from the nodulus/uvula onto the vestibular nucleus via the ICP.

Original languageEnglish
Pages (from-to)2851-2857
Number of pages7
JournalJournal of Neurology
Issue number8
StatePublished - Aug 2021


  • Central positional nystagmus
  • Inferior cerebellar peduncle
  • Nystagmus
  • Vertigo


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