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.

What causes vertical gaze?

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).

What controls vertical eye movement?

The rostral interstitial nucleus or vertical gaze center is located in the rostral part of the midbrain reticular formation and is responsible for vertical movements. Activation of each gaze center separately results in movements of the eyes along a single axis, either horizontal or vertical.

What is vertical gaze?

Vertical gaze palsy refers to the condition in which neither eye moves fully upward or downward. In contrast to horizontal gaze, there are no clinical disorders in which vertical gaze palsy is caused by cerebral hemisphere disease.

What causes horizontal gaze?

Horizontal gaze palsy is usually due to lesions of supranuclear, nuclear, and infranuclear pathways of horizontal of eye movements in the pons. Palsy of all types of horizontal movements implicates the abducens nucleus, whereas palsies of saccades alone are due to lesions of the parapontine reticular formation.

Vertical Gaze

What causes gaze deviation in stroke?

In the case of strokes, restriction of horizontal gaze on one side is usually due to damage of the contralateral frontal cortex or ipsilateral pontine area.

What is horizontal gaze?

Horizontal gaze nystagmus refers to an involuntary jerking of the eyes as the eyes gaze toward the side. In addition to being involuntary, the person experiencing the nystagmus is unaware of its occurrence.

What causes vertical gaze nystagmus?

Vertical Gaze Nystagmus is an up and down jerking of the eyes which occurs when the eyes gaze upward at maximum elevation. The presence of this type of nystagmus is associated with high doses of alcohol for that individual and certain other drugs.

What is responsible for conjugate gaze?

Conjugate gaze is mediated in the brain stem by the medial longitudinal fasciculus, which is a nerve tract that connects the abducens, trochlear, and oculomotor nuclei. These nuclei, in turn, are responsible for the muscles that control eye movements.

What causes Disconjugate eyes?

The most well-recognized syndrome is INO, wherein slowing of the adducting eye is caused by inability of the MLF to conduct high-frequency signals. However, disease affecting the ocular motor nerves, the neuromuscular junction, or the extraocular muscles could also cause saccades to become disconjugate.

Which part of the brain is responsible for saccades?

The parietal lobe and more particularly its posterior part, the PPC, are involved in the control of saccades and attention.

Does the cerebellum affect eye movement?

The cerebellum is an important structure within a widely distributed neural network that controls movements including those of the eyes. Both the immediate online control of movement and the adjustments necessary to optimize motor performance in the long term are under its purview.

Which cranial nerve is responsible for lateral eye movement?

Cranial nerve VI abducts the eye through stimulation of the lateral rectus muscle.

What is loss of horizontal gaze?

Horizontal gaze palsy with progressive scoliosis (HGPPS) is a recessive disorder defined by almost complete limitation of horizontal eye movements with intact vertical gaze, and scoliosis that begins in the first decade of life and is often severe and debilitating.

What is dorsal midbrain syndrome?

Parinaud syndrome is a condition that affects your eyes' ability to move up and down. It's also known as dorsal midbrain syndrome. Most cases are related to a problem with a part of your midbrain known as the tectal plate. Several things can cause Parinaud syndrome.

Which cranial nerve and eye muscles are responsible for the cardinal positions of gaze?

CN 3 (the oculomotor nerve) produces 4 of the 6 positions, CN 6 (the abducens nerve) produces 1 position, and CN 4 (the trochlear nerve) produces 1 position. Eye muscle innervation.

What substance causes vertical nystagmus?

Vertical, horizontal, or rotary nystagmus may be noted. The most common drug/toxin overdoses that cause nystagmus are the following: Anticonvulsants (phenytoin, carbamazepine, valproic acid, lamotrigine, topiramate) Ethanol.

What does a vertical nystagmus indicate?

Consumption of alcohol has been established to cause nystagmus, or an involuntary jerking of the eyes. During the course of a DUI traffic stop, an officer may administer a test to evaluate nystagmus.

Is vertical nystagmus normal?

CONCLUSIONS—Vertical and asymmetric nystagmus are most commonly associated with serious intracranial pathology and its presence is an indication for neuroimaging studies. However, such nystagmus can occur in children with retinal disease, albinism, and in cases with CIN.

How do you conduct horizontal gaze nystagmus?

To administer the test, the officer will hold a small object approximately 12-15 inches from your nose and slowly move it from one side to the other. You will follow the object with your eyes while keeping your head still. The officer will look for three different clues in each (for a total of six) during the test.

What is gaze deviation?

A deviated gaze is an abnormal movement of the eyes. It is often found as a symptom for subdural hematoma or some people may have it from birth.

What causes eye deviation?

Causes. The causes of eye misalignment are various, and sometimes unknown. Potential causes include high farsightedness, thyroid eye disease, cataract, eye injuries, myasthenia gravis, cranial nerve palsies, and in some patients it may be caused by brain or birth problems.

What is ocular deviation?

The strabismus can be manifest (heterotropia), in which one visual axis deviates either constantly or intermittently, or latent (heterophoria), in which the ocular deviation is normally controlled by fusion and only becomes apparent when the eyes are dissociated.

What is the abducens nerve responsible for?

Cranial nerve six (CN VI), also known as the abducens nerve, is one of the nerves responsible for the extraocular motor functions of the eye, along with the oculomotor nerve (CN III) and the trochlear nerve (CN IV).