Supranuclear disorders of gaze in children
- Andrew G Lee, MD
Andrew G Lee, MD
- Professor of Ophthalmology, Neurology, and Neurological Surgery
- Weill Cornell College of Medicine
- Paul W Brazis, MD
Paul W Brazis, MD
- Section Editor — Neuroophthalmology
- Professor of Neurology, Department of Ophthalmology
- Mayo Clinic College of Medicine
- Section Editors
- Evelyn A Paysse, MD
Evelyn A Paysse, MD
- Section Editor — Pediatric Ophthalmology
- Professor of Ophthalmology and Pediatrics
- Baylor College of Medicine
- Douglas R Nordli, Jr, MD
Douglas R Nordli, Jr, MD
- Section Editor — Pediatric Neurology
- Chief of Neurology
- Children’s Hospital Los Angeles
- Vice Chair of Neurology
- USC Keck School of Medicine
Abnormalities in eye movements can be caused by palsy of isolated ocular muscles, palsy of conjugate movements (gaze), or both. The supranuclear disorders of gaze in children are reviewed here. Palsy of isolated extraocular muscles is discussed separately. (See "Evaluation and management of strabismus in children" and "Third cranial nerve (oculomotor nerve) palsy in children" and "Fourth cranial nerve (trochlear nerve) palsy in children" and "Sixth cranial nerve (abducens nerve) palsy in children".)
The control of eye movement has three components:
●The supranuclear pathway (from the cortex and other control centers in the brain to the ocular motor nuclei in the brainstem)
●The ocular motor nuclei
●The infranuclear pathway from the ocular motor nuclei to the peripheral nerve, neuromuscular junction, and extraocular muscles (table 1)To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
- Pierrot-Deseilligny C, Rivaud S, Gaymard B, et al. Cortical control of saccades. Ann Neurol 1995; 37:557.
- Zackon DH, Sharpe JA. Midbrain paresis of horizontal gaze. Ann Neurol 1984; 16:495.
- Masdeu JC, Rosenberg M. Midbrain-diencephalic horizontal gaze paresis. J Clin Neuroophthalmol 1987; 7:227.
- SMITH JL, DAVID NJ. INTERNUCLEAR OPHTHALMOPLEGIA. TWO NEW CLINICAL SIGNS. Neurology 1964; 14:307.
- Zee DS, Hain TC, Carl JR. Abduction nystagmus in internuclear ophthalmoplegia. Ann Neurol 1987; 21:383.
- SMITH JW, COGAN DG. Internuclear ophthalmoplegia; a review of fifty-eight cases. AMA Arch Ophthalmol 1959; 61:687.
- Tijssen CC. Contralateral conjugate eye deviation in acute supratentorial lesions. Stroke 1994; 25:1516.
- Steiner I, Melamed E. Conjugate eye deviation after acute hemispheric stroke: delayed recovery after previous contralateral frontal lobe damage. Ann Neurol 1984; 16:509.
- Robillard A, Saint-Hilaire JM, Mercier M, Bouvier G. The lateralizing and localizing value of adversion in epileptic seizures. Neurology 1983; 33:1241.
- Zee DS. Internuclear ophthalmoplegia: pathophysiology and diagnosis. Baillieres Clin Neurol 1992; 1:455.
- De La Paz MA, Chung SM, McCrary JA 3rd. Bilateral internuclear ophthalmoplegia in a patient with Wernicke's encephalopathy. J Clin Neuroophthalmol 1992; 12:116.
- Galindo M, Pablos JL, Gómez-Reino JJ. Internuclear ophthalmoplegia in systemic lupus erythematosus. Semin Arthritis Rheum 1998; 28:179.
- Hahn JS, Berquist W, Alcorn DM, et al. Wernicke encephalopathy and beriberi during total parenteral nutrition attributable to multivitamin infusion shortage. Pediatrics 1998; 101:E10.
- Zak TA, D'Ambrosio FA Jr. Nutritional nystagmus in infants. J Pediatr Ophthalmol Strabismus 1985; 22:140.
- Kim JH, Hwang JM, Hwang YS, et al. Childhood ocular myasthenia gravis. Ophthalmology 2003; 110:1458.
- Atlas SW, Grossman RI, Savino PJ, et al. Internuclear ophthalmoplegia: MR-anatomic correlation. AJNR Am J Neuroradiol 1987; 8:243.
- Wall M, Wray SH. The one-and-a-half syndrome--a unilateral disorder of the pontine tegmentum: a study of 20 cases and review of the literature. Neurology 1983; 33:971.
- de Seze J, Lucas C, Leclerc X, et al. One-and-a-half syndrome in pontine infarcts: MRI correlates. Neuroradiology 1999; 41:666.
- Bogousslavsky J, Miklossy J, Regli F, Janzer R. Vertical gaze palsy and selective unilateral infarction of the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF). J Neurol Neurosurg Psychiatry 1990; 53:67.
- Hommel M, Bogousslavsky J. The spectrum of vertical gaze palsy following unilateral brainstem stroke. Neurology 1991; 41:1229.
- Zee DS, Freeman JM, Holtzman NA. Ophthalmoplegia in maple syrup urine disease. J Pediatr 1974; 84:113.
- Yee RD, Cogan DG, Zee DS. Ophthalmoplegia and dissociated nystagmus in adetalipoproteinemia. Arch Ophthalmol 1976; 94:571.
- Keane JR. The pretectal syndrome: 206 patients. Neurology 1990; 40:684.
- Chattha AS, Delong GR. Sylvian aqueduct syndrome as a sign of acute obstructive hydrocephalus in children. J Neurol Neurosurg Psychiatry 1975; 38:288.
- Osher RH, Corbett JJ, Schatz NJ, et al. Neuro-ophthalmological complications of enlargement of the third ventricle. Br J Ophthalmol 1978; 62:536.
- Sandyk R. Paralysis of conjugate upward gaze in acute decompensating hydrocephalus. S Afr Med J 1982; 61:261.
- Ohashi T, Fukushima K, Chin S, et al. Ocular tilt reaction with vertical eye movement palsy caused by localized unilateral midbrain lesion. J Neuroophthalmol 1998; 18:40.
- Jauregui-Renaud K, Faldon M, Clarke A, et al. Skew deviation of the eyes in normal human subjects induced by semicircular canal stimulation. Neurosci Lett 1996; 205:135.
- Donahue SP, Lavin PJ, Hamed LM. Tonic ocular tilt reaction simulating a superior oblique palsy: diagnostic confusion with the 3-step test. Arch Ophthalmol 1999; 117:347.
- Brazis PW. Ocular motor abnormalities in Wallenberg's lateral medullary syndrome. Mayo Clin Proc 1992; 67:365.
- Donahue SP, Lavin PJ, Mohney B, Hamed L. Skew deviation and inferior oblique palsy. Am J Ophthalmol 2001; 132:751.
- Parulekar MV, Dai S, Buncic JR, Wong AM. Head position-dependent changes in ocular torsion and vertical misalignment in skew deviation. Arch Ophthalmol 2008; 126:899.
- Wong AM, Colpa L, Chandrakumar M. Ability of an upright-supine test to differentiate skew deviation from other vertical strabismus causes. Arch Ophthalmol 2011; 129:1570.