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  • Title: Upbeat nystagmus from a demyelinating lesion in the caudal pons.
    Author: Tilikete C, Milea D, Pierrot-Deseilligny C.
    Journal: J Neuroophthalmol; 2008 Sep; 28(3):202-6. PubMed ID: 18769284.
    Abstract:
    A 51-year-old man developed positional vertigo, ataxia, dysgeusia, diplopia, and oscillopsia. Eye movement examination and video-oculographic recording disclosed primary position upbeat nystagmus (PPUN) and a right internuclear ophthalmoplegia. Brain MRI showed a small focal lesion in the right dorsal tegmentum of the caudal pons with signal characteristics consistent with a primary demyelinating central nervous system disease. PPUN has not been described previously with a lesion in such a location. Clinicoanatomic correlation in this patient suggests that a lesion of the superior vestibular nucleus and its efferent crossing ventral tegmental tract could be responsible for the PPUN. This case report contributes to a better understanding of the role of this pathway in humans.
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