From the Guidelines
Gaze palsy is a neurological condition characterized by the inability to move both eyes in a specific direction, with vertical supranuclear gaze palsy being a classic finding in progressive supranuclear palsy (PSP) 1.
Definition and Causes
Gaze palsy occurs when there is damage to the brain areas that control eye movements, particularly the brainstem or cerebral cortex. The condition can be caused by various factors, including neurodegenerative diseases such as PSP, which is the most common atypical Parkinsonism with a prevalence of around 5/100,000 1.
Types and Symptoms
There are several types of gaze palsies, including horizontal gaze palsy, vertical gaze palsy, and conjugate gaze palsy. Symptoms typically include double vision, difficulty tracking moving objects, and compensatory head movements to see in the affected direction. In PSP, ocular symptoms, including blurred vision and slow saccades, can be seen early in the disease, with vertical supranuclear gaze palsy usually appearing later in the course of the disease 1.
Diagnosis and Treatment
Diagnosis involves a neurological examination, imaging studies like MRI or CT scans, and sometimes specialized eye movement tests. Treatment focuses on addressing the underlying cause, which may involve medications, surgery, or rehabilitation therapy. Since gaze palsy often indicates serious neurological problems, prompt medical evaluation is essential when symptoms appear. In the case of PSP, treatment is primarily focused on managing symptoms, as there is currently no cure for the disease 1.
From the Research
Definition of Gaze Palsy
- Gaze palsy refers to a condition where an individual has difficulty moving their eyes in a particular direction, often resulting from a lesion or damage to the brainstem or other parts of the ocular motor system 2, 3, 4.
- This condition can manifest as vertical or horizontal gaze palsy, depending on the direction of eye movement affected 5.
Causes of Gaze Palsy
- Gaze palsy can be caused by a variety of factors, including thalamic or mesencephalic infarcts, multiple sclerosis, and vascular lesions 3, 4, 5.
- In some cases, gaze palsy can be a symptom of a larger neurological disorder, such as progressive supranuclear palsy (PSP) 6.
Characteristics of Gaze Palsy
- Individuals with gaze palsy may experience symptoms such as vertical or horizontal diplopia, nystagmus, and difficulty with saccadic or smooth pursuit eye movements 2, 3, 4.
- The specific characteristics of gaze palsy can vary depending on the underlying cause and the location of the lesion or damage 5, 6.
Diagnosis and Treatment of Gaze Palsy
- Diagnosis of gaze palsy typically involves a combination of clinical examination, imaging studies (such as MRI), and optokinetic nystagmus testing 3, 5.
- Treatment of gaze palsy depends on the underlying cause, but may involve rehabilitation therapies, such as physical and occupational therapy, to improve functional and vocational abilities 2.