Conjugate gaze palsy

View paralysis disorders are the same direction eye movements. They come about by lesions of the supranuclear centers in the brain. The restriction of movement of the right and left eye are approximately in "pure " look the same paralysis. A squint is not in these cases generally. Much more common, however, occur with combinations of forms of Paralytic strabismus, as are the views centers in close proximity to the core areas and roots of the cranial nerves III, IV and VI. The presence of strabismus includes therefore a gaze palsy in any way.

Horizontal, unilateral gaze palsy

Persistent view paralysis to one side caused by malfunction of the ipsilateral pontine structures and relate either to the abducens nucleus or the para- median pontine reticular formation ( PPRF ). Here it is noticeable that in damage to the abducens nucleus, all eye movements are disturbed to the side while in lesions of the PPRF the pursuit movements and the vestibulo- ocular reflex ( doll's head phenomenon) are obtained. Only the quick glance target and command movements as well as saccades and fast Nystagmusphasen are disturbed.

Unlike Ponsläsionen lead hemisphere lesions - often after strokes - almost exclusively to temporary paralysis views. Also, look paralyzes find much more frequently to the left as such to the right, suggesting in the right and left hemisphere to a different organization of the processing of gaze pulses.

Horizontal, bilateral gaze palsy

View paralysis to the right and left ( while maintaining the vertical eye movements ) may be due either to bilateral lesions of the abducens nuclei or bilateral lesions on the upper portions of the PPRF. Isolated horizontal gaze palsy with preserved convergence reaction are reported occasionally in congenital form.

Vertical view of paralysis

Disturbances to the rapid eye movements in the vertical plane - so when you look up and down - are limited, can be located securely in the area of the midbrain. All vertical supranuclear eye movement disorders are summarized under the term of Parinaud's syndrome. This isolated paralysis of Abblicks are much less frequent than disorders of Aufblicks. Many patients show a convergent nystagmus, whose origin is not yet clear. Amplify this symptom can be still by offering a optokinetic stimulus pattern that you move from top to bottom. As a simple clinical test, this is of great diagnostic importance.

The vertical gaze palsy is also a diagnostic criterion for progressive supranuclear palsy ( Steele - Richardson - Olszewski syndrome), a neurodegenerative disease with Parkinson -like symptoms.

The vertical gaze palsy is also an important indication of a possible disease of the Niemann -Pick disease. This is a genetic disorder that usually occurs in childhood, can have a fulminant course and is usually diagnosed through ignorance far too late.