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A common cause of horizontal gaze palsies are strokes involving pontine structures, abducens nerve, or the motor cortex. [5] Horizontal gaze palsy has also been reported in cases of metastasis, [6] hemorrhage, [7] neuromyelitis optica spectrum disorder, [8] and multiple sclerosis.
Signs of a person with a gaze palsy may be frequent movement of the head instead of the eyes. [2] For example, a person with a horizontal saccadic palsy may jerk their head around while watching a movie or high action event instead of keeping their head steady and moving their eyes, which usually goes unnoticed. Someone with a nonselective ...
More formally, it is characterized by "a conjugate horizontal gaze palsy in one direction and an internuclear ophthalmoplegia in the other". [1] [2] Nystagmus is also present when the eye on the opposite side of the lesion is abducted. Convergence is classically spared as cranial nerve III (oculomotor nerve) and its nucleus is spared bilaterally.
The diagnostic criteria for Athabaskan brainstem dysgenesis syndrome include: [1] Verification of sensorineural deafness by brainstem auditory evoked responses. [1]Upon conjugate lateral gazing, there is horizontal gaze palsy; however, the medial gaze remains intact with convergence.
Destructive lesions of the PPRF cause ipsilateral horizontal conjugate gaze palsy and mostly impair ipsilateral horizontal saccades, however, other horizontal and vertical eye movements may also be affected as the PPRF contains multiple distinct populations of neurons important in saccade generation, as well as being traversed by nerve fibers ...
Absence of fast phase nystagmus on horizontal optokinetic testing; Problems in nerve function involved in eye movement control, called neuropathy; Inability to visually follow objects; Head thrusts to compensate for the inability to accomplish voluntary horizontal gaze. [2] [3]
Patients will move their heads to adjust for the loss of peripheral vision caused by inability to abduct or adduct the eye. All directions of gaze are affected; however, downward gaze appears to be best spared. This is in contrast to progressive supranuclear palsy (PSP), which typically affects vertical gaze and spares horizontal gaze.
The conjugate gaze is the motion of both eyes in the same direction at the same time, and conjugate gaze palsy refers to an impairment of this function. The conjugate gaze is controlled by four different mechanisms: [4] the saccadic system that allows for voluntary direction of the gaze; the pursuit system that allows the subject to follow a ...