What is vertical supranuclear gaze palsy?
What is vertical supranuclear gaze palsy?
A supranuclear gaze palsy is an inability to look in a vertical direction as a result of cerebral impairment. There is a loss of the voluntary aspect of eye movements, but, as the brainstem is still intact, all the reflex conjugate eye movements are normal. [ from HPO]
What causes vertical gaze palsy?
A lesion of the vertical gaze pathways can occur from a number of causes: Tumor- pineal germinoma or teratoma (classically seen in adolescent male), pineocytoma, pineoblastoma, tecal glioma, or metastasis. VGP can also occur secondary to paraneoplastic effect (ex. anti-MA2 encephalitis).
Does PSP affect eyesight?
Frequently, people with PSP feel stiffness in the neck and back, and their movements may be slowed. A person with PSP will begin to experience eye problems, such as difficulty opening and closing their eyes, blinking, blurry vision, or moving their eyes side to side or up and down.
How do I examine for a supranuclear gaze palsy?
How do I examine for a supranuclear gaze palsy (SNGP)? Assessment is best undertaken in a hierarchical way; initially assess saccades to command, then saccades to targets, then smooth pursuit of a target, and finally with the vestibul‐ocular reflex (VOR).
What causes gaze palsy?
The most common cause of vertical gaze palsy is damage to the top part of the brain stem (midbrain), usually by a stroke or tumor. In upward vertical gaze palsies, the pupils may be dilated. When people with this palsy look up, they have nystagmus. That is, their eye rapidly moves upward, then slowly drifts downward.
What does gaze palsy mean?
A conjugate gaze palsy is inability to move both eyes together in a single horizontal (most commonly) or vertical direction.
How do you treat gaze palsy?
Treatment. There is no treatment of conjugate gaze palsy itself, so the disease or condition causing the gaze palsy must be treated, likely by surgery. As stated in the causes section, the gaze palsy may be due to a lesion caused by stroke or a condition.
What is responsible for vertical gaze?
The vertical gaze is controlled by the rostral interstitial nucleus of medial longitudinal fasciculus and the interstitial nucleus of Cajal.