[Slow-upward ocular bobbing in a patient with striatonigral degeneration]

We herein report a patient with the abnormal eye movement characterized by a conjugate slow-upward eye movement followed by a fast-downward movement to the primary position (slow-upward ocular bobbing). A 55-year-old man with a 12 years' history of striatonigral degeneration developed pneumonia and was admitted to our hospital. In addition to the parkinsonian features like akinesia and rigidity, examination revealed slow-upward ocular bobbing. There were no accompanying ocular abnormalities. This spontaneous eye movement was recognized throughout his stay in the hospital, irrespective of his consciousness level. Although other forms of ocular bobbing/dipping are usually associated with the loss of consciousness, all three reported patients with this slow-upward ocular bobbing were awake and responsive, therefore, suggesting a different kind of background pathophysiology in this unique eye sign.