[Ocular bobbing. A new hypothesis].

Three of 4 patients with ocular bobbing were typical cases while in the last case the ocular disorder was asymmetric. A neuropathologic study was conducted in 2 cases. In both use, findings included variable degrees of pontine destruction without lesion of the medulla, with extension of the lesion into the mesencephalon in 1 case. The various physiopathogenic hypotheses put forward are reviewed but none appears satisfactory. A new hypothesis is proposed, based on available clinico-pathologic data (35 published and 2 personal cases) and recent experimental studies. Two centers, one mesencephalic, the other in the medulla, could exist that would generate saccadic movements downwards, and in the pons a center would provoke inhibition of saccadic movements. Destruction of the latter could activate spontaneous saccadic movements downwards (the only possible ones remaining) with the condition that the mesencephalic generating center and its pathways are intact.