Paralysis of downgaze in two patients with clinical-radiologic correlation

J. P. Green, N. J. Newman and J. S. Winterkorn
Department of Ophthalmology, Emory University School of Medicine, Atlanta, Ga.

Selective downgaze paralysis was correlated with discrete bilateral lesions at the mesencephalic-diencephalic junction in a 9-year-old girl following severe pneumococcal meningitis, and in a 64-year-old man who suffered an embolic infarction. Magnetic resonance imaging demonstrated bilateral lesions in the region of the rostral interstitial nucleus of the medial longitudinal fasciculus. Clinical-radiologic correlation allowed identification of the likely vascular cause in both patients.

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