Vestibular imbalance associated with a lesion in the nucleus prepositus hypoglossi area.
BACKGROUND
The nucleus prepositus hypoglossi (NPH) is known to be a neural integrator of horizontal eye movements. Although the role of the human NPH is not well known, it may also function in postural balance, in view of its anatomic connections with the vestibular nuclei and vestibulocerebellum and of lesion studies in experimental animals.


OBJECTIVE
To show that the human NPH contributes to vestibular function in addition to eye movement control.


METHODS
Case series.


METHODS
University hospital. Patients Six patients with small and discrete brainstem infarctions that predominantly involved the NPH region.Main Outcome Measure Findings on magnetic resonance images.


RESULTS
The NPH was affected at the lower pontine level in 2 patients and at the upper medullary level in 4. In addition to gaze-evoked nystagmus, all patients had vertigo, vomiting, and postural ataxia, suggesting vestibular dysfunction. The patients typically fell contralaterally or bilaterally to the lesion side.


CONCLUSIONS
The NPH serves a vestibular function in addition to its oculomotor control function.
Seo
Sang Won
SW
Department of Neurology, Brain Research Institute, Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Shinchon-dong 134, Seodaemoon-ku, Seoul 120-752, Korea.
Shin
Ha Young
HY
Kim
Seo Hyun
SH
Han
Sang Won
SW
Lee
Kyung Yul
KY
Kim
Seung Min
SM
Heo
Ji Hoe
JH
D000368:Aged; D000369:Aged, 80 and over; D001259:Ataxia / Q000209:etiology; D020520:Brain Infarction / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008526:Medulla Oblongata / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D009434:Neural Pathways / Q000502:physiology; D009759:Nystagmus, Pathologic / Q000209:etiology; D011859:Radiography; D014717:Vertigo / Q000209:etiology; D015837:Vestibular Diseases / Q000209:etiology*; D014726:Vestibular Nuclei / Q000000981:diagnostic imaging / Q000473:pathology