title: Combined ipsilateral oculomotor nerve palsy and contralateral downbeat nystagmus in a case of cerebral infarction.
abstract: We report a patient with acute cerebral infarction of the left paramedian thalamus, upper mesencephalon and cerebellum who exhibited ipsilateral oculomotor nerve palsy and contralateral downbeat nystagmus. The site of the infarction was considered to be the paramedian thalamopeduncular and cerebellar regions, which are supplied by the superior cerebellar artery containing direct perforating branches or both the superior cerebellar artery and the superior mesencephalic and posterior thalamosubthalamic arteries. Contralateral and monocular downbeat nystagmus is very rare. Our case suggests that the present downbeat nystagmus was due to dysfunction of cerebellar-modulated crossed oculovestibular fibers of the superior cerebellar peduncle or bilateral downbeat nystagmus with one-sided oculomotor nerve palsy.
authors.affiliation: Department of Neurology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Matsuzono
authors.affiliation: Department of Neurology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Manabe
authors.affiliation: Department of Neurology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Neurology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Narai
authors.affiliation: Department of Neurology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Omori
authors.affiliation: Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Abe
keywords: Infarction; Monocular downbeat nystagmus; Oculomotor nerve palsy; Superior cerebellar peduncle