Unilateral thalamic infarction and vertical gaze palsy: cause or coincidence?
Although vertical gaze palsy (VGP) is commonly associated with lesions of the rostral mesencephalon, there is some evidence that VGP may also be caused by a unilateral thalamic lesion. The case of a 68-year-old man with persistent upward gaze palsy after a unilateral thalamic infarction, demonstrated on computed tomography and magnetic resonance imaging scans, is presented. Subsequent high-resolution magnetic resonance scanning, however, showed involvement of the rostral mesencephalon as well. The authors suggest that in previous patients with VGP ascribed to a unilateral thalamic infarction, a coexisting mesencephalic involvement may have been missed because of inappropriate imaging techniques. Strong evidence of unilateral thalamic infarction as a cause of VGP is still lacking.
van der Graaff
M M
MM
Department of Neurology, St. Lucas Andreas Hospital, Amsterdam, The Netherlands.
Vanneste
J A
JA
Davies
G A
GA
D000368:Aged; D020520:Brain Infarction / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000473:pathology; D015835:Ocular Motility Disorders / Q000150:complications* / Q000175:diagnosis / Q000209:etiology*; D013786:Thalamic Diseases / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed