Ocular bobbing refers to intermittent abnormal vertical eye movements, usually conjugate, consisting of a fast downward movement followed by a slow return to the initial horizontal eye position. The sign has no precise localizing value, but is most commonly associated with intrinsic
pontine lesions, e.g., infarct, hemorrhage, tumor, central pontine myelinolysis. It has also been described in encephalitis, Creutzfeldt-Jakob disease, and toxic encephalopathies. Its pathophysiology is uncertain but may involve mesencephalic and medullary burst neurone centres.
Variations on the theme include:
- Inverse ocular bobbing: slow downward movement, fast return (also known as fast upward ocular bobbing, or ocular dipping)
- Reverse ocular bobbing: fast upward movement, slow return to midposition
- Converse ocular bobbing: slow upward movement, fast down (also known as slow upward ocular bobbing, or reverse ocular dipping).
Fisher CM. Ocular bobbing. Archives of Neurology 1964; 11: 543-546 Bosch EP, Kennedy SS, Aschenbrener CA. Ocular bobbing: the myth of its localizing value. Neurology 1975; 25: 949-953