Homeobox-containing genes En-1 and En-2 have been implicated in the control of pattern formation during development of the central nervous system in experimental animals. In order to determine whether the expression of homologous human EN genes can be used as a developmental genetic marker of the arcuate nucleus of the medulla (a putative precerebellar nucleus that shows developmental deficiency in a subset of sudden infant death syndrome [SIDS]), we performed in situ hybridization with human EN1 and EN2 RNA probes in human fetal midgestational medulla and cerebellum (18-21 weeks gestational age, n=4). Expression of EN genes was demonstrated in all neuronal groups of the medulla and throughout the cerebellum. The RNA signal for both EN1 and EN2 was strongest in the cerebellar granule cell layers, white matter of the vermis and flocculus, inferior olive, arcuate nucleus, caudal raphe nuclei, corpus pontobulbare and nucleus ambiguus. Most of the structures that showed the strongest EN signal originate in the rhombic lip. Some of these structures are functionally interconnected, and show pathologic changes in the syndrome of infantile olivopontocerebellar hypoplasia/atrophy. Strong expression of EN signal in the arcuate nucleus could be used as a genetic marker of this nucleus in further developmental studies of the arcuate nucleus in SIDS. Although EN expression is not specific to the arcuate nucleus or to the rhombic lip derivatives, our results suggest that rhombic lip derivatives have the highest levels of EN RNA message among the medullary structures at midgestation.