A woman aged 60 years developed a Millard-Gubler syndrome after a diagnosis of a cavernous angioma in the median and paramedian areas of the pons. In this context, she presented a right VI nerve palsy, right conjugate gaze palsy, facial palsy and left hemiparesis. To improve the complete VI nerve palsy, we planned a modified transposition approach, in which procedure we made a partial transposi...

Five patients with "locked-in" syndrome and dysconjugate palsy of horizontal gaze were studied. In all cases internuclear ophthalmoplegia due to dysfunction or destruction of the median longitudinal fasciculus was combined with an ipsilateral gaze palsy, producing the "one-and-a-half" syndrome. Clinical and electro-oculographic examination suggested involvement of the paramedian pontine reticul...

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...

Jerome J. Graber, MD, MPH Robert Staudinger, MD, FAAN An 82-year-old man presented to us with a 2-year history of progressive difficulty walking. On examination, he had bradykinesia, bradyphrenia, axial rigidity without appendicular rigidity, cogwheeling, or tremor, and restriction of upward and downward gaze. Imaging revealed prominent midbrain atrophy without pontine atrophy, referred to as t...

Progressive Supranuclear Palsy (PSP) is an atypical Parkinsonism noted for postural instability, early falls, and a supranuclear vertical gaze palsy. However, since its original description, several variants were described. One of the rarer variants is PSP-C, further adding to the diverse clinical. As a result, misdiagnosis of PSP-C as multiple system atrophy, or a spinocerebellar degeneration ...

PURPOSE To report isolated upgaze palsy in a patient with a dolichoectatic vertebrobasilar artery. CASE REPORT We report a 48-year-old man who showed upgaze palsy and convergence insufficiency. The left vertebral artery and basilar artery were shown to be greatly expanded, elongated and tortuous in cranial magnetic resonance imaging (MRI). The vertebrobasilar artery runs along the sulcus basi...

Lesions affecting the dorsal midbrain can result in a constellation of ocular findings such as vertical gaze disturbances, convergence retraction nystagmus, light-near dissociation of pupils, and eyelid retraction. Although bilateral superior oblique palsy can occur after a stroke, its occurrence secondary to nontraumatic brainstem hemorrhage is extremely rare. We report a combination of dorsal...