Wernekinck commissure syndrome is a rare midbrain syndrome, usually resulting in selective destruction of the decussation of the superior cerebellar peduncle. This syndrome can present with symptoms such as bilateral cerebellar ataxia, ophthalmoplegia, and palatal tremor. Here, we report a 61-year-old female with acute onset of bilateral cerebellar ataxia and isolated superior rectus palsy diagnosed on Wernekinck commissure syndrome confirmed by magnetic resonance imaging.

Incongruous visual field defects, such as sectoranopia, can result from lateral geniculate nucleus infarction. We present a rare case of right lateral geniculate nucleus infarction that manifests as a left inferior homonymous paracentral scotoma. According to the retinotopic organization of the visual tract, central vision from the macula is delivered to the occipital pole via the posterior portion of the lateral geniculate nucleus. Consequently, not only can occipital pole infarction lead to central visual loss, but partial lateral geniculate nucleus infarction can also produce similar manifestations of central visual loss.