Clinical Approach to Supranuclear Brainstem Saccadic Gaze Palsies

Failure of brainstem supranuclear centers for saccadic eye movements results in the clinical presence of a brainstem-mediated supranuclear saccadic gaze palsy (SGP), which is manifested as slowing of saccades with or without range of motion limitation of eye movements and as loss of quick phases of...

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Published in:Frontiers in neurology 2017-08, Vol.8, p.429-429
Main Authors: Lloyd-Smith Sequeira, Alexandra, Rizzo, John-Ross, Rucker, Janet C
Format: Article
Language:English
Subjects:
burst neuron
Neuroscience
progressive supranuclear palsy
saccades
slow saccades
supranuclear
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description Failure of brainstem supranuclear centers for saccadic eye movements results in the clinical presence of a brainstem-mediated supranuclear saccadic gaze palsy (SGP), which is manifested as slowing of saccades with or without range of motion limitation of eye movements and as loss of quick phases of optokinetic nystagmus. Limitation in the range of motion of eye movements is typically worse with saccades than with smooth pursuit and is overcome with vestibular-ocular reflexive eye movements. The differential diagnosis of SGPs is broad, although acute-onset SGP is most often from brainstem infarction and chronic vertical SGP is most commonly caused by the neurodegenerative condition progressive supranuclear palsy. In this review, we discuss the brainstem anatomy and physiology of the brainstem saccade-generating network; we discuss the clinical features of SGPs, with an emphasis on insights from quantitative ocular motor recordings; and we consider the broad differential diagnosis of SGPs.
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subjects burst neuron
Neuroscience
progressive supranuclear palsy
saccades
slow saccades
supranuclear
title Clinical Approach to Supranuclear Brainstem Saccadic Gaze Palsies
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