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Differential Diagnosis for Fixed Right Sided Gaze

  • Single most likely diagnosis
    • Hemispatial neglect: This condition is characterized by a patient's inability to attend to or perceive stimuli on one side of their body or environment, often resulting from a contralateral brain lesion, typically in the parietal lobe. A fixed gaze towards the neglected side could be a manifestation of this condition as the patient may have difficulty moving their gaze towards the neglected side.
  • Other Likely diagnoses
    • Frontal eye field lesion: The frontal eye fields are responsible for controlling saccadic eye movements. A lesion in this area, often due to stroke or trauma, could result in a patient having difficulty moving their gaze away from the side of the lesion, potentially presenting as a fixed gaze.
    • Parietal lobe syndrome: In addition to hemispatial neglect, parietal lobe lesions can cause a variety of symptoms including apraxia, agraphia, and right-left disorientation. A fixed gaze could be part of the constellation of symptoms.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Stroke or cerebral vasculitis: These conditions can cause sudden onset of neurological deficits, including gaze paresis. Early recognition and treatment are crucial to prevent further brain damage.
    • Brain tumor: A tumor in the brain, particularly in areas controlling eye movement, could cause a fixed gaze. Prompt diagnosis and treatment are essential to improve outcomes.
  • Rare diagnoses
    • Progressive supranuclear palsy (PSP): A rare neurodegenerative disorder that can cause vertical gaze palsy, but in some cases, may also affect horizontal gaze. It's a diagnosis to consider in patients with progressive neurological decline and gaze abnormalities.
    • Möbius syndrome: A rare congenital neurological disorder characterized by facial paralysis and impaired eye movements, which could potentially present with a fixed gaze. However, this would typically be identified at birth or in early childhood.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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