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Bilateral thalamic infarction associated with selective downward gaze paralysis.

M Kobari, N Ishihara, K Yunoki

    European Neurology
    |January 1, 1987
    PubMed
    Summary

    Downward gaze paralysis after ischemic stroke suggests specific brainstem and thalamic infarction. This finding aids in pinpointing the stroke

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    Area of Science:

    • Neurology
    • Neuroimaging
    • Vascular Neurology

    Background:

    • Oculomotor disturbances can indicate specific neurological lesions.
    • Understanding the neuroanatomy of gaze control is crucial for diagnosing brainstem and thalamic injuries.

    Observation:

    • A 34-year-old male experienced temporary downward gaze palsy, impaired convergence, and significant psychological symptoms.
    • Cranial computed tomography (CT) and magnetic resonance imaging (MRI) revealed symmetrical infarction in the bilateral thalami and rostral medial midbrain.

    Findings:

    • Ischemic stroke affecting the bilateral thalami and rostral medial midbrain.
    • Downward gaze paralysis correlated with the specific infarction pattern.

    Implications:

    • Downward gaze paralysis serves as a key diagnostic marker for specific ischemic stroke locations.
    • Identifying the responsible artery can be facilitated by recognizing this clinical sign.

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