Vertical Gaze Palsy

Author Name : Dr. V. Hemavathy, Prof. Girijabaskaran, F. Preethi

ABSTRACT

A vertical gaze palsy (VGP) is a conjugate, bilateral, limitation of the eye movements in upgaze and/or downgaze. VGP can affect functional eye movements by selectively involving the saccadic pathway and may spare or involve spare smooth pursuit or optokinetic movements or non-selectively involve VGP for all types of eye movements. Eye movements can also be anatomically classified into supranuclear, nuclear, and infranuclear. In regards to this chapter on VGP, the focus is on supranuclear pathways involving three major anatomical structures. Combined bilateral lesions of the nuclear or infranuclear pathways including the neuromuscular junction (e.g., myasthenia gravis, MG) or muscles (e.g., restrictive thyroid ophthalmopathy) can also mimic VGP, but are usually asymmetric and in contrast to supranuclear VGP cannot be overcome with vestibulo-ocular reflex (VOR) or the doll’s head maneuver.

KEYWORDS: vertical gaze palsy, eye disorder, neuro disorder