title: Supranuclear eye movement abnormalities.
abstract: OBJECTIVE
  The components of the efferent ocular motor network include supranuclear, nuclear, internuclear, infranuclear, neuromuscular junction, and muscle. Within this schema, clinicians are often least acquainted with the supranuclear components; however, derangement of this system is a common cause of ocular dysmotility and diplopia. This article will provide the neurologist with an overview of the anatomy and clinical aspects of the supranuclear ocular motor control systems.
  
  
  RESULTS
  Continued research moves us toward a more complete understanding of the anatomy and physiology of the complex networks providing supranuclear control of eye movements. This background serves as a framework for the application of clinical techniques, such as bedside assessment of the vestibuloocular reflex, localizing limitations of conjugate gaze (eg, midbrain lesions affecting vertical gaze), and derangements of specific classes of eye movements (pursuit and saccadic dissociation in conditions such as Parinaud dorsal midbrain syndrome).
  
  
  CONCLUSIONS
  The efferent neuro-ophthalmic system is a complex series of networks that function to provide accurate control of eye movements, visual stabilization, and ocular alignment. Disturbance within these networks can produce diplopia; impaired control of eye movement, such as gaze palsy; or unwanted eye movements, such as nystagmus.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Eggenberger
mesh_terms: D000368:Aged; D002540:Cerebral Cortex / Q000473:pathology*; D005133:Eye Movements / Q000502:physiology* / Q000528:radiation effects; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000209:etiology / Q000473:pathology*; D012027:Reflex, Vestibulo-Ocular / Q000502:physiology
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