brain, spinal cord, and nerve disorders
Conjugate Gaze Palsies
Vertical gaze palsy
Vertical (upward and downward) gaze decreases gradually with age, but vertical gaze palsy is more severe than age-related changes. Usually, upward gaze is affected. The most common cause of vertical gaze palsy is damage to the top part of the brain stem (midbrain), usually by a stroke or tumor. Inupward vertical gaze palsies,the pupils may be dilated. When people with this palsy look up, they have nystagmus. That is, their eye rapidly moves upward, then slowly drifts downward. is an upward vertical gaze palsy. It usually results from a Pineal Tumors pressing on the area of the brain that controls vertical gaze or from a stroke. People with Parinaud syndrome tend to look down. Their eyelids are pulled back, and the pupils are dilated. They may also have nystagmus. but not upward gaze is impaired, the cause is usually Progressive Supranuclear Palsy (PSP) . 