title: Nucleus prepositus hypoglossi lesions produce a unique ocular motor syndrome.
abstract: OBJECTIVE
  To describe the ocular motor abnormalities in 9 patients with a lesion involving the nucleus prepositus hypoglossi (NPH), a key constituent of a vestibular-cerebellar-brainstem neural network that ensures that the eyes are held steady in all positions of gaze.
  
  
  METHODS
  We recorded eye movements, including the vestibulo-ocular reflex during head impulses, in patients with vertigo and a lesion involving the NPH.
  
  
  RESULTS
  Our patients showed an ipsilesional-beating spontaneous nystagmus, horizontal gaze-evoked nystagmus more intense on looking toward the ipsilesional side, impaired pursuit more to the ipsilesional side, central patterns of head-shaking nystagmus, contralateral eye deviation, and decreased vestibulo-ocular reflex gain during contralesionally directed head impulses.
  
  
  CONCLUSIONS
  We attribute these findings to an imbalance in the NPH-inferior olive-flocculus-vestibular nucleus loop, and the ocular motor abnormalities provide a new brainstem localization for patients with acute vertigo.
authors.affiliation: From the Department of Neurology (S.-H.K.), Kyungpook National University School of Medicine, Daegu, Korea; Departments of Neurology, Ophthalmology, Otolaryngology-Head and Neck Surgery, and Neuroscience (D.S.Z., S.d.L.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Biomedical Laboratory Science (H.J.K.), Kyungdong University, Goseong-Gun, Gangwon-do; and Department of Neurology (J.-S.K.), Seoul National University College of Medicine, Seoul National University Bundang Hospital, Korea.
authors.forename: Sung-Hee
authors.initials: SH
authors.lastname: Kim
authors.affiliation: From the Department of Neurology (S.-H.K.), Kyungpook National University School of Medicine, Daegu, Korea; Departments of Neurology, Ophthalmology, Otolaryngology-Head and Neck Surgery, and Neuroscience (D.S.Z., S.d.L.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Biomedical Laboratory Science (H.J.K.), Kyungdong University, Goseong-Gun, Gangwon-do; and Department of Neurology (J.-S.K.), Seoul National University College of Medicine, Seoul National University Bundang Hospital, Korea.
authors.forename: David S
authors.initials: DS
authors.lastname: Zee
authors.affiliation: From the Department of Neurology (S.-H.K.), Kyungpook National University School of Medicine, Daegu, Korea; Departments of Neurology, Ophthalmology, Otolaryngology-Head and Neck Surgery, and Neuroscience (D.S.Z., S.d.L.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Biomedical Laboratory Science (H.J.K.), Kyungdong University, Goseong-Gun, Gangwon-do; and Department of Neurology (J.-S.K.), Seoul National University College of Medicine, Seoul National University Bundang Hospital, Korea.
authors.forename: Sascha
authors.initials: S
authors.lastname: du Lac
authors.affiliation: From the Department of Neurology (S.-H.K.), Kyungpook National University School of Medicine, Daegu, Korea; Departments of Neurology, Ophthalmology, Otolaryngology-Head and Neck Surgery, and Neuroscience (D.S.Z., S.d.L.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Biomedical Laboratory Science (H.J.K.), Kyungdong University, Goseong-Gun, Gangwon-do; and Department of Neurology (J.-S.K.), Seoul National University College of Medicine, Seoul National University Bundang Hospital, Korea.
authors.forename: Hyo Jung
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: From the Department of Neurology (S.-H.K.), Kyungpook National University School of Medicine, Daegu, Korea; Departments of Neurology, Ophthalmology, Otolaryngology-Head and Neck Surgery, and Neuroscience (D.S.Z., S.d.L.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Biomedical Laboratory Science (H.J.K.), Kyungdong University, Goseong-Gun, Gangwon-do; and Department of Neurology (J.-S.K.), Seoul National University College of Medicine, Seoul National University Bundang Hospital, Korea. jisookim@snu.ac.kr.
authors.forename: Ji-Soo
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000368:Aged; D002150:Caloric Tests; D005260:Female; D007839:Functional Laterality; D019416:Head Movements / Q000502:physiology; D006801:Humans; D007002:Hypoglossal Nerve / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000209:etiology*; D015835:Ocular Motility Disorders / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D012027:Reflex, Vestibulo-Ocular / Q000502:physiology; D014726:Vestibular Nuclei / Q000000981:diagnostic imaging / Q000473:pathology*