Neurocysticercosis presenting as a vertical one-and-a-half syndrome with associated contralesional horizontal gaze paresis

Contraversive Ocular Tilt Reaction with Contralesional Pseudo-Abducens Palsy in a Patient with Thalamomesencephalic Stroke

“…Since there was no simultaneous acute microvascular lesion in the contralateral pons, affecting the abducens nerve or its fibers, the abduction deficit observed in our patient was most likely due to pseudo-abducens palsy which is commonly associated with supranuclear vertical gaze palsy [ 11 – 13 ]. These abduction deficits associated with upgaze palsy occur in lesions involving [ 11 , 14 ] the frontopontine horizontal gaze pathway situated adjacent to the riMLF/INC and projecting to the abducens nucleus [ 15 , 16 ]; the internuclear fibers from the medial rectus oculomotor subnucleus to the contralateral abducens nucleus producing contralesional abduction deficit [ 17 ]; and finally, in lesions affecting the inhibitory convergence pathways traveling to the midbrain “near-response” neurons or injury to pathways or neurons that compose the vergence integrator increased convergence activity [ 18 ].…”