Pursuit gaze defects in acute and chronic unilateral parieto-occipital lesions

Isolated abnormalities of pursuit gaze were studied in 8 patients with unilateral acute (hemorrhage) or chronic (tumor) lesions of the parieto-occipital lobes. Ipsilateral pursuit was impaired in all patients, being superimposed with cogwheel saccades. Foveal pursuit was more disturbed than full-field pursuit. Impairment of contralateral pursuit was observed in all patients, but was severe only after acute involvement of the nondominant hemisphere. These findings provide further evidence for some asymmetric organization of hemispheric command of ocular movements. In these patients with hemianopia, the bilateral alterations of pursuit gaze probably correspond to an inter- and intrahemispheric disconnection syndrome.