Ocular bobbing in metabolic encephalopathy: clinical, pathologic, and electrophysiologic study

A patient with atypical ocular bobbing resulting from metabolic encephalopathy is described. Neurologic examination showed no signs of brainstem dysfunction, and postmortem examination failed to disclose any changes in sites associated with ocular bobbing in other reports. However, brainstem auditory evoked responses showed evidence of bilateral dysfunction of brainstem white matter. This is the first demonstration of functional disturbance in brainstem loci that are thought to be responsible for the infrequently observed ocular bobbing in metabolic encephalopathy.