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Selective saccadic palsy caused by pontine lesions: Clinical, physiological, and pathological correlations
Author(s) -
Hanson Maurice R.,
Hamid Mohamed A.,
Tomsak Robert L.,
Chou Samuel S.,
Leigh R. John
Publication year - 1986
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.410200206
Subject(s) - saccadic masking , pathological , medicine , physical medicine and rehabilitation , palsy , neuroscience , eye movement , psychology , pathology , alternative medicine
Two patients suffered a selective deficit of voluntary saccades and quick phases of nystagmus after hypoxic–ischemic insults during open‐heart surgery. All voluntary saccades, in both horizontal and vertical planes, were slow, and quick phases of vestibular and optokinetic nystagmus were absent. Smooth pursuit, the vestibuloocular reflex, the ability to hold steady eccentric gaze, and vergence eye movements were all preserved. Pathological studies in 1 patient confirmed neuronal necrosis and gliosis, consistent with ischemic lesions involving the median and paramedian pontine reticular formation and median basis pontis but sparing the rostral mesencephalon and rostral interstitial nucleus of the medial longitudinal fasciculus. These findings, taken with data from experimental studies, support the hypothesis that each functionally defined class of horizontal eye movements is controlled by a separate neural substrate that projects independently to the abducens nuclei. In addition, these data suggest that the rostral interstitial nucleus of the medial longitudinal fasciculus is dependent on inputs from the paramedian pontine reticular formation for the programming of normal vertical saccades.