Premium
Midbrain paresis of horizontal gaze
Author(s) -
Zackon David H.,
Sharpe James A.
Publication year - 1984
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410160411
Subject(s) - gaze , midbrain , paresis , psychology , medicine , neuroscience , computer vision , computer science , surgery , central nervous system
Unilateral paramedian involvement of the midbrain tegmentum causes monocular paralysis of adduction in the ipsilateral eye, paresis of contralateral saccades in the opposite eye, and conjugate paresis of ipsilateral smooth pursuit. The adduction paralysis can be nuclear, or internuclear from a lesion in the medial longitudinal fasciculus. This distinctive midbrain syndrome of horizontal gaze paresis is exemplified by means of quantitative infrared oculographic, radiological, and neuropathological correlation in two patients with predominantly paramedian midbrain tumors involving the mesencephalic reticular formation and the oculomotor nucleus. Binocular paralysis of elevation provided evidence that one human oculomotor nucleus contains axons to both superior rectus muscles, as does the simian oculomotor nucleus. The midbrain tectum was spared. These pathophysiological correlations indicate that the mesencephalic reticular formation contains pathways that control contralateral saccades and ipsilateral smooth pursuit.