Vertebro-basilar syndromes causing oculo-motor disorders.
OBJECTIVE
All functional classes of eye movements require exquisite coordination between cortical, basal ganglia and brainstem centers involved in ocular motor control. Vertebrobasilar stroke may produce a wide spectum of isolated or combined eye-movement disorders. The intent of this article is to summarize the curent knowledge of eye-movement disorders occurring in infarcts involving the different arterial territories of the vertebrobasilar circulation.


RESULTS
In the last few years there has been an improvement in our understanding of pathophysiological mechanisms that are related mainly to abnormal vergence disorders due to thalamic-subthalamic infarcts, as well as of the peculiar symptoms resulting from otolith pathway involvement occurring in lateral medullary infarcts. Moreover, progress in neuroimaging technology has implicated neurovascular contact of the trochlear nerve in instances of superior oblique myokimia.


CONCLUSIONS
Eye-movement disorders commonly occur in vertebrobasilar stroke, although they are often unappreciated. They may make it possible to establish specific anatomical correlates, as well as the probable nature of the underlying pathology.
Moncayo
Jorge
J
Department of Neurology, Eugenio Espejo University Hospital, Quito, Ecuador.
Bogousslavsky
Julien
J
D001479:Basal Ganglia / Q000503:physiopathology; D001933:Brain Stem / Q000503:physiopathology; D002540:Cerebral Cortex / Q000503:physiopathology; D006801:Humans; D009434:Neural Pathways / Q000503:physiopathology; D015835:Ocular Motility Disorders / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D013577:Syndrome; D014715:Vertebrobasilar Insufficiency / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology