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A case of horizontal gaze palsy

A case of horizontal gaze palsy

Folia Ophthalmologica Japonica 40(1): 162-167

The case of a 27-year-old woman with right horizontal gaze palsy is reported. Her eye position was orthophoric and slightly deviated conjugately to the left. She could not move her eyes to the right at all. Both saccadic and smooth pursuit eye movements were slowed. Convergence and vestibulo-ocular reflexes were disturbed. However, there were no findings on cranial nerve and other neurological examinations. A high-density area was found in the right pontine tegmentum on CT scan; pontine tumor was suspected. MRI showed an extremely small and well-defined lesion. We therefore concluded that the lesion was localized in the right pontine paramedian reticular formation (PPRF). Recent literature on horizontal gaze palsy and the usefulness of MRI for identifying brainstem lesions is also discussed.

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