Fig. 1. Images of the patient in nine diagnostic positions of gaze, demonstrating bilateral vertical gaze palsy. (A) The pupils are dilated in both eyes because these photographs were taken after the dilated fundus examination. (B,C) Fundus photographs showed incyclotorsion of the right eye and excyclotorsion of the left eye. (D) Diffuse-weighted magnetic resonance imaging shows high signal in the right upper midbrain. (E) Images of the patient in nine diagnostic positions of gaze, demonstrating normal upward and downward ocular movement in the both eyes one month later.