Hypermetric Saccades

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Horizontal saccades are hypermetric to the right and to the left, which requires a refixation saccade. This is typical of a dysfunction of the fastigial nucleus which is responsible for the accuracy and not the velocity of saccades.

Horizontal saccades are hypermetric to the right and to the left, which requires a refixation saccade. This is typical of a dysfunction of the fastigial nucleus which is responsible for the accuracy and not the velocity of saccades.

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).