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. 1990 Mar;53(3):194–199. doi: 10.1136/jnnp.53.3.194

Abnormalities of horizontal gaze. Clinical, oculographic and magnetic resonance imaging findings. I. Abducens palsy.

A M Bronstein 1, J Morris 1, G Du Boulay 1, M A Gresty 1, P Rudge 1
PMCID: PMC1014127  PMID: 2324751

Abstract

Fifty one patients with abnormalities of horizontal gaze were studied with magnetic imaging of the brain (MRI) and eye movement recordings to identify the loci of lesions responsible for isolated abducens palsy, conjugate gaze palsy and different types of internuclear ophthalmoplegias. The lesions responsible for a particular disorder were identified by overlapping enlarged drawings of the individual scans at comparable brain-stem levels and identifying the areas where the abnormal MRI signals intersected. A statistical procedure was devised to exclude the possibility that the areas of overlap occurred by chance. In this paper, the findings in the group of patients with VI nerve palsy are reported since the location of their lesions could be predicted from known anatomy, so validating the procedure. The results were independently obtained with the overlapping technique and the statistical procedure and showed that the lesions were located in a region corresponding to the posterior part of the abducens fasciculus. This confirms that central lesions producing isolated lateral rectus weakness spare the abducens nuclei. The agreement between the procedures used and earlier clinical and experimental results suggest that the method we describe can be applied to locate the site of lesions on MRI scans in other groups of patients with more complex gaze disorders.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Atlas S. W., Grossman R. I., Savino P. J., Schatz N. J., Sergott R. C., Bosley T. M., Hackney D. B., Goldberg H. I., Bilaniuk L. T., Zimmerman R. A. Internuclear ophthalmoplegia: MR-anatomic correlation. AJNR Am J Neuroradiol. 1987 Mar-Apr;8(2):243–247. [PMC free article] [PubMed] [Google Scholar]
  2. Bird A. C., Leech J. Internuclear ophthalmoplegia. An electro-oculographic study of peak angular saccadic velocities. Br J Ophthalmol. 1976 Sep;60(9):645–651. doi: 10.1136/bjo.60.9.645. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bogousslavsky J., Fox A. J., Carey L. S., Vinitski S., Bass B., Noseworthy J. H., Ebers G. C., Barnett H. J. Correlates of brain-stem oculomotor disorders in multiple sclerosis. Magnetic resonance imaging. Arch Neurol. 1986 May;43(5):460–463. doi: 10.1001/archneur.1986.00520050040019. [DOI] [PubMed] [Google Scholar]
  4. Bronstein A. M., Rudge P., Gresty M. A., Du Boulay G., Morris J. Abnormalities of horizontal gaze. Clinical, oculographic and magnetic resonance imaging findings. II. Gaze palsy and internuclear ophthalmoplegia. J Neurol Neurosurg Psychiatry. 1990 Mar;53(3):200–207. doi: 10.1136/jnnp.53.3.200. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Büttner-Ennever J. A., Henn V. An autoradiographic study of the pathways from the pontine reticular formation involved in horizontal eye movements. Brain Res. 1976 May 21;108(1):155–164. doi: 10.1016/0006-8993(76)90171-2. [DOI] [PubMed] [Google Scholar]
  6. CARPENTER M. B., McMASTERS R. E., HANNA G. R. Disturbances of conjugate horizontal eye movements in the monkey. I. Physiological effects and anatomical degeneration resulting from lesions of the abducens nucleus and nerve. Arch Neurol. 1963 Mar;8:231–247. doi: 10.1001/archneur.1963.00460030015001. [DOI] [PubMed] [Google Scholar]
  7. Cohen B., Henn V. Unit activity in the pontine reticular formation associated with eye movements. Brain Res. 1972 Nov 13;46:403–410. doi: 10.1016/0006-8993(72)90030-3. [DOI] [PubMed] [Google Scholar]
  8. Fuchs A. F., Kaneko C. R., Scudder C. A. Brainstem control of saccadic eye movements. Annu Rev Neurosci. 1985;8:307–337. doi: 10.1146/annurev.ne.08.030185.001515. [DOI] [PubMed] [Google Scholar]
  9. Goebel H. H., Komatsuzaki A., Bender M. B., Cohen B. Lesions of the pontine tegmentum and conjugate gaze paralysis. Arch Neurol. 1971 May;24(5):431–440. doi: 10.1001/archneur.1971.00480350065007. [DOI] [PubMed] [Google Scholar]
  10. Graybiel A. M., Hartwieg E. A. Some afferent connections of the oculomotor complex in the cat: an experimental study with tracer techniques. Brain Res. 1974 Dec 13;81(3):543–551. doi: 10.1016/0006-8993(74)90850-6. [DOI] [PubMed] [Google Scholar]
  11. Highstein S. M., Baker R. Excitatory termination of abducens internuclear neurons on medial rectus motoneurons: relationship to syndrome of internuclear ophthalmoplegia. J Neurophysiol. 1978 Nov;41(6):1647–1661. doi: 10.1152/jn.1978.41.6.1647. [DOI] [PubMed] [Google Scholar]
  12. Highstein S. M., Maekawa K., Steinacker A., Cohen B. Synaptic input from the pontine reticular nuclei to absucens motoneurons and internuclear neurons in the cat. Brain Res. 1976 Aug 6;112(1):162–167. doi: 10.1016/0006-8993(76)90344-9. [DOI] [PubMed] [Google Scholar]
  13. Hood J. D., Korres S. Vestibular suppression in peripheral and central vestibular disorders. Brain. 1979 Dec;102(4):785–804. doi: 10.1093/brain/102.4.785. [DOI] [PubMed] [Google Scholar]
  14. Joseph R., Pullicino P., Goldberg C. D., Rose F. C. Bilateral pontine gaze palsy. Nuclear magnetic resonance findings in presumed multiple sclerosis. Arch Neurol. 1985 Jan;42(1):93–94. doi: 10.1001/archneur.1985.04060010103027. [DOI] [PubMed] [Google Scholar]
  15. Mantel N. Approaches to a health research occupancy problem. Biometrics. 1974 Jun;30(2):355–362. [PubMed] [Google Scholar]
  16. Ormerod I. E., Bronstein A., Rudge P., Johnson G., Macmanus D., Halliday A. M., Barratt H., Du Boulay E. P., Kendal B. E., Moseley I. F. Magnetic resonance imaging in clinically isolated lesions of the brain stem. J Neurol Neurosurg Psychiatry. 1986 Jul;49(7):737–743. doi: 10.1136/jnnp.49.7.737. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ormerod I. E., Miller D. H., McDonald W. I., du Boulay E. P., Rudge P., Kendall B. E., Moseley I. F., Johnson G., Tofts P. S., Halliday A. M. The role of NMR imaging in the assessment of multiple sclerosis and isolated neurological lesions. A quantitative study. Brain. 1987 Dec;110(Pt 6):1579–1616. doi: 10.1093/brain/110.6.1579. [DOI] [PubMed] [Google Scholar]
  18. Pierrot-Deseilligny C., Goasguen J. Isolated abducens nucleus damage due to histiocytosis X. Electro-oculographic analysis and physiological deductions. Brain. 1984 Dec;107(Pt 4):1019–1032. doi: 10.1093/brain/107.4.1019. [DOI] [PubMed] [Google Scholar]

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