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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1996 May;60(5):579–581. doi: 10.1136/jnnp.60.5.579

Monocular elevation paresis and contralateral downgaze paresis from unilateral mesodiencephalic infarction.

G Wiest 1, C Baumgartner 1, P Schnider 1, S Trattnig 1, L Deecke 1, C Mueller 1
PMCID: PMC486376  PMID: 8778268

Abstract

A 26 year old woman presented with monocular elevation paresis of the right eye, contralateral paresis of downward gaze, and subtle bilateral ptosis. Magnetic resonance imaging disclosed a unilateral embolic infarction restricted to the mesodiencephalic junction involving the left paramedian thalamus. Preserved vertical oculocephalic movements and intact Bell's phenomenon suggested a supranuclear lesion. This rare "crossed vertical gaze paresis" results from a lesion near the oculomotor nucleus affecting ipsilateral downward gaze and contralateral upward gaze fibres, originating in the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF).

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Selected References

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