Downbeat nystagmus: A case report of herpetic brain stem encephalitis

Lawrence W. Hirst, Arthur W. Clark, Jerry S. Wolinsky, David S. Zee, Herbert Kaizer, Neil R. Miller, Peter J. Tutschka, George W. Santos

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


A 35-year-old man with aplastic anemia developed prominent downbeat nystagmus 80 days after receiving an allogeneic bone marrow transplant. A diagnosis of herpes simplex encephalitis was made which was confirmed by positive virus cultures at autopsy 1 week later. Routine pathologic examination of the brain stem revealed no lesions which would explain the downbeat nystagmus. Immunoperoxidase studies, however, revealed virus-infected neurones throughout the brain stem including the nuclei of the basis pontis, the superior olive, and nuclei of the spinal tracts of 5 and 10. The significance of “negative” pathologic brain stem findings in cases of downbeat nystagmus is discussed.

Original languageEnglish (US)
Pages (from-to)245-249
Number of pages5
JournalJournal of Clinical Neuro-Ophthalmology
Issue number4
StatePublished - Dec 1983

ASJC Scopus subject areas

  • Ophthalmology
  • Clinical Neurology


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