Central positional nystagmus arises due to disruption of brainstem or cerebellar vestibular networks. Most of patients with central positional nystagmus had lesions focal or diffusion cerebellar or pontine lesion. From a clinical perspective, the presence of central positional nystagmus is thus highly predictive of lesions in the posterior fossa, including the vestibular apparatus, brainstem vestibular nuclei, and midline cerebellar structures within the vermis. We experienced central positional nystagmus in focal infarction in dentate nucleus.