Supranuclear horizontal gaze palsy

Horizontal Supranuclear Gaze Palsy Video 2

Patient should perform smooth pursuit eye movements to the right and to the left. They are highly restricted. 20 seconds: Patient should perform vertical eye movements. They are limited, in particular for upward gaze with a reduced range of movement. 45: Patient should perform vertical saccades. They are almost normal. 1 minute: Patient should perform horizontal saccades. They are bilaterally severely impaired.

Underlying Treatable Conditions

Patient should perform smooth pursuit eye movements to the right and to the left. They are highly restricted. 20 seconds: Patient should perform vertical eye movements. They are limited, in particular for upward gaze with a reduced range of movement. 45: Patient should perform vertical saccades. They are almost normal. 1 minute: Patient should perform horizontal saccades. They are bilaterally severely impaired.

Combined vertical and horizontal gaze palsy indicates a pontine brainstem lesion in the rostral interstitial nucleus of the medial longitudinal fascicle (riMLF) and the ipsilateral paramedian pontine reticular formation (PPRF).