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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 ...
Upon conjugate lateral gazing, there is horizontal gaze palsy; however, the medial gaze remains intact with convergence. [1] Central hypoventilation shown by hypoxia and/or respiratory acidosis without an underlying neuromuscular or lung disease. [1] Developmental delays. [1]
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.
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 ...
4. Iatrogenic injury. Abducens nerve palsy is also known to occur with halo orthosis placement. The resultant palsy is identified through loss of lateral gaze after application of the orthosis and is the most common cranial nerve injury associated with this device. [9]
Foville's syndrome is caused by the blockage of the perforating branches of the basilar artery in the region of the brainstem known as the pons. [1] It is most frequently caused by lesions such as vascular disease and tumors involving the dorsal pons.
It has less commonly been associated with spasm of accommodation on attempted upward gaze, pseudoabducens palsy (also known as thalamic esotropia) or slower movements of the abducting eye than the adducting eye during horizontal saccades, see-saw nystagmus and associated ocular motility deficits including skew deviation, oculomotor nerve palsy ...