[Unilateral paralysis of saccades caused by pontine tuberculoma]

A unilateral lesion of the paramedian pontine reticular formation results in an ipsilateral laterality paralysis with abolition of all saccadic movements directed to the side of the lesion. It is generally accepted that the oculocephalic reflex alone enables the eyes to be deviated beyond the median line of the affected side. In the present case of a paramedian pontine tuberculoma, a paralysis of laterality in accordance with the above mentioned opinion was observed initially. Treatment led to recovery of an ipsilateral pursuit of normal amplitude, contrasting with the persistent abolition of ipsilateral saccadic movements. The significance of this dissociation is discussed together with that of the later reappearance of slow voluntary movements (slow saccadic movements) towards the affected side.