title: Acquired bilateral superior oblique palsy: a localising sign in the dorsal midbrain.
abstract: Bilateral superior oblique palsy is an uncommon ocular motility problem, the commonest cause being closed head trauma. Two cases, both adults, are presented in whom bilateral superior oblique palsy occurred as a result of neoplastic infiltration of the dorsal midbrain in the region of the anterior medullary velum. In the absence of a history of head trauma, the presence of an acquired bilateral superior oblique palsy is a definite sign of a single lesion in the region of the decussation of the trochlear nerves and appropriate imaging is indicated.
authors.affiliation: Tennent Institute of Ophthalmology, Glasgow, United Kingdom.
authors.forename: D B
authors.initials: DB
authors.lastname: Barr
authors.forename: R M
authors.initials: RM
authors.lastname: McFadzean
authors.forename: D
authors.initials: D
authors.lastname: Hadley
authors.forename: A
authors.initials: A
authors.lastname: Ramsay
authors.forename: C A
authors.initials: CA
authors.lastname: Houston
authors.forename: D
authors.initials: D
authors.lastname: Russell
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000556:secondary; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009408:Nerve Compression Syndromes / Q000209:etiology / Q000473:pathology; D009801:Oculomotor Muscles / Q000473:pathology; D009886:Ophthalmoplegia / Q000209:etiology* / Q000473:pathology; D010870:Pineal Gland / Q000473:pathology*; D010871:Pinealoma / Q000150:complications / Q000175:diagnosis*; D014321:Trochlear Nerve / Q000473:pathology