SUPRANUCLEAR DISORDERS OF EYE MOVEMENT. 1. Horizontal gaze palsies. Internuclear ophthalmoplegia Combined internuclear and PPRF (‘one-and-a-half syndrome’). MLF. 2. Vertical gaze palsies. Parinaud dorsal midbrain syndrome Progressive supranuclear palsy.
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1. Horizontal gaze palsies
2. Vertical gaze palsies
Lesion involving left MLF
Normal left gaze
Defective left adduction and ataxic
nystagmus of right eye
Convergence intact if lesion discrete
Combined lesion of left MLF and PPRF
( Steele-Richardson-Olszewski syndrome )
Initially involves downgaze
Subsequent defective up and