Ocular Motor and Vestibular Disorders in Brainstem Disease

Woo Young Choi, Daniel R. Gold

Research output: Contribution to journalReview articlepeer-review


The brainstem contains ocular motor and vestibular structures that, when damaged, produce specific eye movement disorders. In this review, we will discuss three brainstem syndromes with characteristic ocular motor and vestibular findings that can be highly localizing. First, we will discuss the lateral medullary (Wallenberg) syndrome, focusing on ocular lateropulsion, saccadic dysmetria, and the ocular tilt reaction. Second, we will review the medial longitudinal fasciculus syndrome including the ocular tilt reaction, nystagmus, and the vestibular-ocular reflex. Lastly, we will discuss hypertrophic olivary degeneration and oculopalatal tremor, which may develop weeks to months after a brainstem or cerebellar lesion. In these syndromes, the clinical ocular motor and vestibular examination is instrumental in localizing the lesion.

Original languageEnglish (US)
Pages (from-to)396-404
Number of pages9
JournalJournal of Clinical Neurophysiology
Issue number6
StatePublished - Nov 1 2019


  • Brainstem
  • Lateral medullary stroke
  • Medial longitudinal fasciculus
  • Ocular motor
  • Oculopalatal tremor
  • Vestibular

ASJC Scopus subject areas

  • Physiology
  • Neurology
  • Clinical Neurology
  • Physiology (medical)


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