| Title |
Unilateral Midbrain Infarction Causing Upward and Downward Gaze Palsy |
| Creator |
Alemdar, M; Kamaci, S; Budak, F |
| Affiliation |
Department of Neurology, Faculty of Medicine, University of Kocaeli, Kocaeli, Turkey. drmuratalemdar@yahoo.com |
| Abstract |
We report on a 47-year-old-woman who developed sudden complete loss of vertical saccades, smooth pursuit, and vestibular eye movements bilaterally. MRI revealed a unilateral midbrain infarct involving the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF) and the interstitial nucleus of Cajal (INC) and spared the posterior commissure (PC). The lesion is presumed to have interrupted the pathways involved in vertical gaze just before they decussate, inducing an anatomically unilateral but functionally bilateral lesion. Previous reports of bidirectional vertical gaze palsy have shown lesions involving the PC or both riMLFs. This case is the first to show that a unilateral lesion of the riMLF and the INC that spares the PC may cause complete bidirectional vertical gaze palsy. |
| Subject |
Brain Infarctionm, complications; Female; Functional Laterality, physiology; Humans; Magnetic Resonance Imaging, methods; Mesencephalon, pathology; Middle Older people; Ocular Motility Disorders, etiology |
| Format |
application/pdf |
| Publication Type |
Journal Article |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/ |
| Publisher |
Lippincott, Williams & Wilkins |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Rights Management |
© North American Neuro-Ophthalmology Society |
| Setname |
ehsl_novel_jno |
| ID |
225522 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6s217mp/225522 |
