Use the direction of gaze deviation, ocular bobbing, and the posturing pattern to localize the lesion before ordering more tests. These are bedside localization clues, not isolated findings to list back mechanically.

Ocular bobbing is a classic sign that localizes structurally to a pontine lesion; Result is flexion in the arms combined with extension in the legs; This happens because the rubrospinal tract remains intact and actively facilitates flexion of the upper extremities; This specific finding is associated with bilateral cerebral hemisphere dysfunction; With a frontal cortical lesion, the individual looks away from the side of the hemiparesis, and the gaze deviation can be successfully overcome using the oculocephalic maneuver