DR. BHOSALE DHANANJAY ANKUSH
Dr.Aditi Pai, DR. ATUL KAMATH, Dr.Manjunath Kamath M
Abstract
Vertical gaze palsy is a recognized manifestation of midbrain lesion. It rarely is a consequence of unilateral thalamic infarction.
CASE PRESENTATION-
A 48-year-old male patient with history of hypertension, and no history diabetes and hyperlipidemia presented to our facility with acute onset of dizziness and vertical diplopia. A physical examination revealed upward gaze paresis, which could be overcome by the doll’s eye maneuver and skew deviation of the right eye. There was slight worsening of the degree of narrowing when the head was rotated to the right. A magnetic resonance imaging (MRI) scan, which was performed 12 hours after the onset of symptoms, showed an acute right paramedian thalamic infarct.
CONCLUSION-
The combination of vertical gaze paresis & skew deviation, were pointing to a brainstem lesion, may now be attributed to a broader spectrum of anatomical areas. MRI findings need to be studied in order to establish the role of the thalamus in vertical gaze
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