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Abstract
A 72-year-old woman revealed a DBN in all fields of gaze, being a distinct nystagmus particularly observed when she was looking upwards. Saccadic eye movements showed either hyper-metria or hypometria. Optokinetic nystagmus was disturbed in the vertical direction, especially in the downward direction of the slow nystagmus component, when the stripes of the stimulating optokinetic pattern moved downward. Interruptions of the nystagmus by square wave jerks were observed. In addition to the DBN, impairment of the Vlth, Vllth, and VHIth cranial nerves was also present, due to a severe disease in early childhood. Neither computer tomography and nuclear magnetic imaging of the brainstem, nor SPECT perfusion-scintigraphy revealed any cerebral lesion.