Parinaud’s Vertical Ophthalmoplegia

Wall-eyed bilateral inter nuclear ophthalmoplegia with vertical gaze palsy.

A 64-year-old woman, diabetic and hypertensive, presented with sudden onset painless diplopia and alteration of consciousness. She was drowsy with neurological examination revealing exotropia of both eyes in primary position with bilateral internuclear ophthalmoplegia on attempted horizontal gaze (Figure 1a). Pupils were normal bilaterally. Convergence, vertical saccades, pursuits and vestibula...

Vertical ophthalmoplegia due to a unilateral periaqueductal gray matter infarct in an adolescent.

Brainstem strokes affecting the periaqueductal gray matter of the midbrain can cause vertical ophthalmoplegia. Accompanying clinical features are frequently associated and reflect the involvement of other brainstem structures. We report on an adolescent presenting with vertical gaze palsy and left mydriatic pupil as the only clinical expression of a small infarct located in the left periaqueduc...

Vertical gaze ophthalmoplegia from infarction in the area of the posterior thalamo-subthalamic paramedian artery.

Three cases of a stroke syndrome of acute supranuclear vertical gaze ophthalmoplegia are presented. Voluntary vertical gaze and the vertical vestibulo-ocular reflex were absent or diminished initially in all three patients. The patients also had loss of convergence and alteration in their mental status. Computed tomography scans showed lesions in the region of the rostral midbrain and lower die...

Experimental internuclear ophthalmoplegia.

A midline experimental lesion separating the medial longitudinal fasciculi at and below the level of the abducens nuclei without damaging either fasciculus at the level of the nuclei has produced defects of ocular motility resembling those of clinical internuclear ophthalmoplegia. Electromyographic recordings during lateral gaze demonstrate: (1) lack of inhibition of the lateral rectus muscle i...

Congenital external ophthalmoplegia.