Positional upbeat nystagmus on uprighting due to uvulo‐nodular infarction presenting as persistent vertigo and ataxia

Abstract

We report a patient with severe and prolonged vertigo and ataxia caused by infarction of the bilateral cerebellar nodulus and uvula. Vertigo and nausea persisted for 2 weeks, causing the patient to remain bedridden. The patient showed upbeat nystagmus (UBN) on upward gaze and upon uprighting from the supine position and did not exhibit apogeotropic nystagmus characteristic of central paroxysmal positional nystagmus. Isolated positional UBN may be specific to an uvulo‐nodular lesion, and persistent and marked vertigo suggests extensive damage to the bilateral nodulus and uvula.