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Paralysis of upwards gaze: Downward gaze is usually preserved. This vertical palsy is supranuclear, so doll's head maneuver should elevate the eyes, but eventually all upward gaze mechanisms fail. In the extreme form, conjugate down gaze in the primary position, or the "setting-sun sign" is observed.
Vertical gaze palsies affect movement of one or both eyes either in upward direction, up and down direction, or more rarely only downward direction. Very rarely only movement of one eye in one direction is affected. Vertical gaze palsies are often caused by lesions to the midbrain due to a stroke or a tumor.
A third cause of light-near dissociation is Parinaud syndrome, also called dorsal midbrain syndrome. This uncommon syndrome involves vertical gaze palsy associated with pupils that “accommodate but do not react." [5] The causes of Parinaud syndrome include brain tumors (pinealomas), multiple sclerosis and brainstem infarction.
Conjugate gaze palsy: Conjugate gaze palsies typically affect horizontal gaze, although some affect upward gaze. Few affect downward gaze. Few affect downward gaze. These effects can range in severity from a complete lack of voluntary eye movement to mild impairments in speed, accuracy or range of eye movement.
An alternative anatomical cause is a lesion of the abducens nucleus (VI) on one side (resulting in a failure of abduction of the ipsilateral eye and adduction of the contralateral eye = conjugate gaze palsy towards affected side), with interruption of the ipsilateral medial longitudinal fasciculus after it has crossed the midline from its site ...
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 ...
n November 1954, 29-year-old Sammy Davis Jr. was driving to Hollywood when a car crash left his eye mangled beyond repair. Doubting his potential as a one-eyed entertainer, the burgeoning performer sought a solution at the same venerable institution where other misfortunate starlets had gone to fill their vacant sockets: Mager & Gougelman, a family-owned business in New York City that has ...
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 ...