title: Vestibular imbalance associated with a lesion in the nucleus prepositus hypoglossi area.
abstract: 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.
authors.affiliation: 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.
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Seo
authors.forename: Ha Young
authors.initials: HY
authors.lastname: Shin
authors.forename: Seo Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Han
authors.forename: Kyung Yul
authors.initials: KY
authors.lastname: Lee
authors.forename: Seung Min
authors.initials: SM
authors.lastname: Kim
authors.forename: Ji Hoe
authors.initials: JH
authors.lastname: Heo
mesh_terms: 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