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Related Experiment Video

Updated: Jan 29, 2026

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How Do I Examine for a Supranuclear Gaze Palsy?

Tim Anderson1

  • 11Christchurch and the New Zealand Brain Research Institute University of Otago Christchurch New Zealand.

Movement Disorders Clinical Practice
|February 5, 2019
PubMed
Summary

Supranuclear gaze palsy (SNGP) is an eye movement disorder. Assessment involves a hierarchy from verbal commands to the vestibulo-ocular reflex (VOR) to determine severity.

Keywords:
VORsaccadessmooth pursuitsupranuclear gaze palsyvestibulo‐ocular reflex

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Area of Science:

  • Ophthalmology
  • Neurology
  • Neuroscience

Background:

  • Supranuclear gaze palsy (SNGP) is a conjugate gaze limitation, typically affecting vertical eye movements.
  • SNGP can manifest as limitations in saccades, smooth pursuit, or vestibulo-ocular reflex (VOR).

Purpose of the Study:

  • To describe a hierarchical method for assessing supranuclear gaze palsy (SNGP).
  • To differentiate SNGP severity based on the ability to overcome gaze limitations.

Main Methods:

  • Assessing saccades to verbal command.
  • Evaluating saccades to visual targets.
  • Testing smooth pursuit of a moving visual target.
  • Utilizing the vestibulo-ocular reflex (VOR) with passive head rotation.

Main Results:

  • Mild SNGPs are overcome by verbal commands or visual targets.
  • Moderate SNGPs may be overcome by smooth pursuit.
  • Severe SNGPs are only overcome by the VOR.

Conclusions:

  • A hierarchical assessment approach is recommended for SNGP.
  • The hierarchy progresses from simple commands to complex reflex testing.
  • This method aids in classifying SNGP severity and guiding clinical management.