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[Complex eye movement disturbance in thalamic and mesencephalic infarcts].
Ideggyogy Sz. 2006 May 20; 59(5-6):193-200.IS

Abstract

A 36 year-old male patient developed sudden double vision and gait imbalance. Neurological examination revealed gaze paresis upward and on the left side downward (vertical "one-and-a-half"-syndrome), horizontal gaze nystagmus on the left bulbus directed to left. The MRI revealed bilateral thalamic and left midbrain ischemic lesions. The brainstem auditory and visual evoked responses were normally configured. Optokinetic nystagmus test found rightward, upward and downward hypometric saccades, convergence-retraction nystagmus--which was not visible at physical neurological examination--saccadic smooth pursuit eye movement and pseudoabducent palsy on both sides. The complex gaze disturbance was attributed to the lesions in the intralaminar nuclei of the thalamus and in the pretectal and rostromedial tegmentum of the mesencephalon. Infarcts may have been due to a variant artery: i.e. the thalamoperforant and the superior paramedian mesencephalic arteries originate with common branch from one of the communicant basilar artery. The authors discuss the mechanism of complex gaze palsy and call attention to the diagnostic value of optokinetic nystagmus examination.

Authors+Show Affiliations

Semmelweis Egyetem, Altalános Orvostudományi Kar, Neurológiai Klinika, Budapest. szilvi@neur.sote.huNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

hun

PubMed ID

16786714

Citation

Gulyás, Szilvia, et al. "[Complex Eye Movement Disturbance in Thalamic and Mesencephalic Infarcts]." Ideggyogyaszati Szemle, vol. 59, no. 5-6, 2006, pp. 193-200.
Gulyás S, Nagy F, Szirmai I. [Complex eye movement disturbance in thalamic and mesencephalic infarcts]. Ideggyogy Sz. 2006;59(5-6):193-200.
Gulyás, S., Nagy, F., & Szirmai, I. (2006). [Complex eye movement disturbance in thalamic and mesencephalic infarcts]. Ideggyogyaszati Szemle, 59(5-6), 193-200.
Gulyás S, Nagy F, Szirmai I. [Complex Eye Movement Disturbance in Thalamic and Mesencephalic Infarcts]. Ideggyogy Sz. 2006 May 20;59(5-6):193-200. PubMed PMID: 16786714.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Complex eye movement disturbance in thalamic and mesencephalic infarcts]. AU - Gulyás,Szilvia, AU - Nagy,Ferenc, AU - Szirmai,Imre, PY - 2006/6/22/pubmed PY - 2006/8/23/medline PY - 2006/6/22/entrez SP - 193 EP - 200 JF - Ideggyogyaszati szemle JO - Ideggyogy Sz VL - 59 IS - 5-6 N2 - A 36 year-old male patient developed sudden double vision and gait imbalance. Neurological examination revealed gaze paresis upward and on the left side downward (vertical "one-and-a-half"-syndrome), horizontal gaze nystagmus on the left bulbus directed to left. The MRI revealed bilateral thalamic and left midbrain ischemic lesions. The brainstem auditory and visual evoked responses were normally configured. Optokinetic nystagmus test found rightward, upward and downward hypometric saccades, convergence-retraction nystagmus--which was not visible at physical neurological examination--saccadic smooth pursuit eye movement and pseudoabducent palsy on both sides. The complex gaze disturbance was attributed to the lesions in the intralaminar nuclei of the thalamus and in the pretectal and rostromedial tegmentum of the mesencephalon. Infarcts may have been due to a variant artery: i.e. the thalamoperforant and the superior paramedian mesencephalic arteries originate with common branch from one of the communicant basilar artery. The authors discuss the mechanism of complex gaze palsy and call attention to the diagnostic value of optokinetic nystagmus examination. SN - 0019-1442 UR - https://www.unboundmedicine.com/medline/citation/16786714/[Complex_eye_movement_disturbance_in_thalamic_and_mesencephalic_infarcts]_ DB - PRIME DP - Unbound Medicine ER -