Alternations of eye movements induced by visual stimulation in a patient with acute cerebellar infarction

We had the opportunity to investigate a patient with acute cerebellar infarction with edema that extended to the brainstem, using CT-scan and electrooculography (EOG). The purpose of this paper was to analyze the pursuit eye movements, saccades, optokinetic nystagmus (OKN) and fixation-suppression of the caloric test in an acute cerebellar infarction and on CT-scans to evaluate the connections between eye movements and lesions in the vestibulocerebellum. At the onset of infarction, data of the eye movements suggested that the lesioned area involved the bilateral dorsal pontine tegmentum and bilateral cerebellum, although the left side was predominantly impaired, as judged from the CT-scans. After more than 3 weeks from onset, deviation of the fourth ventricle and compression to the brainstem due to edema were not observed. Nevertheless, the parameters of conjugate eye movements that were analyzed had not recovered completely. This suggests that impairment of a neural integrator may still exist.