What is an upward gaze?
Abstract. Paroxysmal tonic upward gaze constitutes a neuro-ophthalmologic syndrome characterized by episodes of sustained conjugate upward deviation of the eyes, normal horizontal gaze, and ataxia. Its pathogenesis is unknown, and the etiology is heterogeneous. The prognosis is variable.
What is responsible for vertical gaze?
The vertical gaze is controlled by the rostral interstitial nucleus of medial longitudinal fasciculus and the interstitial nucleus of Cajal.
Where is the vertical gaze Centre?
midbrain reticular formation
The rostral interstitial nucleus or vertical gaze center is located in the rostral part of the midbrain reticular formation and is responsible for vertical movements. Activation of each gaze center separately results in movements of the eyes along a single axis, either horizontal or vertical.
What does downward gaze mean?
Impaired voluntary vertical gaze, especially downward, with preservation of reflex vertical movements (doll’s-eye maneuver) usually indicates progressive supranuclear palsy Progressive Supranuclear Palsy (PSP) Progressive supranuclear palsy is a rare, degenerative central nervous system disorder that progressively …
What causes parinaud syndrome?
Anything that causes unusual swelling or pressure in your brain may cause Parinaud syndrome. The most common causes include: brain tumors in the midbrain region or pineal gland. stroke.
What does a downward gaze mean?
Vertical gaze palsies are often caused by lesions to the midbrain due to a stroke or a tumor. In the case that only downward gaze is affected, the cause is normally progressive supranuclear palsy.
What is horizontal and vertical gaze?
So for horizontal gaze, the final common pathway for horizontal gaze lives in the pons, and that is mediated by the parapontine reticular formation and the sixth nerve nucleus. This is horizontal pathway. The vertical pathway lives at the junction of the thalamus and the midbrain, the thalamomesencephalic junction.
What is Benedikt syndrome?
Benedikt syndrome is an eponymously named neurological condition secondary to specific damage in the midbrain that causes ipsilateral oculomotor nerve palsy, contralateral hemiparesis, and contralateral cerebellar ataxia and/or Holmes tremor and/or choreoathetosis.
What causes vertical gaze palsy in PSP?
The vertical gaze palsy of PSP has been attributed to the midbrain pathology affecting the tectum and the superior colliculi.
What causes a deviated gaze?
Common causes include strokes for horizontal gaze palsies, midbrain lesions (usually infarcts and tumors) for vertical gaze palsies, and progressive supranuclear palsy for downward gaze palsies. Treat the underlying disorder.