Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four patients with congenital double elevator palsy were studied who had clinically brisk elevation of the affected eye from downgaze to the midline position of rest, but severely limited or absent elevation above primary position. Forced duction tests were negative and Bell's phenomenon was present preoperatively in all patients. To clarify why upgaze saccades clinically seemed intact below but not above midline, vertical saccadic velocities were measured using the scleral search coil technique. The tracings of three cases suggest sufficient superior rectus function to generate a normal upward saccadic trajectory. A supranuclear lesion is the most likely etiology of the inability to elevate the eye well above primary position in these three patients. In a fourth patient, the reduced ability to elevate the affected eye above primary position is caused by a superior rectus paresis with decreased upward saccadic velocities. We suggest at least three distinct groups of patients present clinically as double elevator palsy: primary inferior rectus restriction, primary superior rectus paresis or palsy, and congenital supranuclear elevation deficiency.
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PMID:Congenital double elevator palsy: vertical saccadic velocity utilizing the scleral search coil technique. 812 Jul 49

A 26 year old woman presented with monocular elevation paresis of the right eye, contralateral paresis of downward gaze, and subtle bilateral ptosis. Magnetic resonance imaging disclosed a unilateral embolic infarction restricted to the mesodiencephalic junction involving the left paramedian thalamus. Preserved vertical oculocephalic movements and intact Bell's phenomenon suggested a supranuclear lesion. This rare "crossed vertical gaze paresis" results from a lesion near the oculomotor nucleus affecting ipsilateral downward gaze and contralateral upward gaze fibres, originating in the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF).
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PMID:Monocular elevation paresis and contralateral downgaze paresis from unilateral mesodiencephalic infarction. 877 68

Claude's syndrome caused by dorsal midbrain lesion is characterized by ipsilateral third nerve palsy and contralateral ataxia. To date, reports in the literature concerning Claude's syndrome associated with the midbrain paresis of horizontal gaze are rare. A 62-year-old man suddenly developed left third cranial nerve palsy, right lateral gaze palsy, and right ataxia. Intact Bell's phenomenon and preserved right horizontal oculocephalic reflex suggested the lateral gaze palsy in the right eye was supranuclear in nature. Magnetic resonance imaging (MRI) revealed an infarction in the left dorsomedial midbrain. Although the red nucleus has often been suggested as the lesion site responsible for Claude's syndrome, a lesion of the superior cerebellar peduncle just below and medial to the red nucleus could be responsible for this syndrome. This case demonstrates neurological heterogeneity of midbrain infarction.
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PMID:Claude's syndrome associated with supranuclear horizontal gaze palsy caused by dorsomedial midbrain infarction. 1625 18