Document Detail

Paresis of lateral gaze alternating with so-called posterior internuclear ophthalmoplegia. A partial paramedian pontine reticular formation-abducens nucleus syndrome.
MedLine Citation:
PMID:  3998774     Owner:  NLM     Status:  MEDLINE    
A patient with multiple myeloma developed gaze paresis to the left with slowed saccades and gaze-paretic nystagmus, which alternated with abduction palsy in the left eye (with preserved oculocephalic deviation) and dissociated adducting nystagmus in the right eye, suggesting so-called posterior internuclear ophthalmoplegia. At autopsy multiple small infarcts were found with partial destruction of the left paramedian pontine reticula formation (PPRF) extending towards the abducens nucleus, which was involved only in its inferior pole. The medial longitudinal fasciculus and other oculomotor structures were spared. It is suggested that slowing of all ipsilateral saccades with gaze-paretic nystagmus corresponded to partial destruction of the PPRF, and that intermitted abduction palsy in the ipsilateral eye with adduction nystagmus in the fellow eye was due to intermittant dysfunction of the abducens nucleus. Involvement of voluntary saccades, pursuit movements and vestibulo-ocular responses may be dissociated in partial lesions of the abducens nucleus.
J Bogousslavsky; F Regli; B Ostinelli; T Rabinowicz
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurology     Volume:  232     ISSN:  0340-5354     ISO Abbreviation:  J. Neurol.     Publication Date:  1985  
Date Detail:
Created Date:  1985-07-19     Completed Date:  1985-07-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0423161     Medline TA:  J Neurol     Country:  GERMANY, WEST    
Other Details:
Languages:  eng     Pagination:  38-42     Citation Subset:  IM    
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MeSH Terms
Abducens Nerve / pathology,  physiopathology*
Cerebral Infarction / pathology,  physiopathology
Dominance, Cerebral / physiology
Middle Aged
Multiple Myeloma / physiopathology
Nystagmus, Physiologic
Ophthalmoplegia / pathology,  physiopathology*
Pons / pathology,  physiopathology*
Reticular Formation / pathology,  physiopathology*

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