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Article
September 1980

Ocular LateropulsionA Sign of Lateral Medullary Disease

Author Affiliations

From the Departments of Ophthalmology (Drs Meyer, Krohel, and Hepler) and Neurology (Dr Baloh), UCLA School of Medicine, Los Angeles. Dr Krohel is now with Albany (NY) Medical College.

Arch Ophthalmol. 1980;98(9):1614-1616. doi:10.1001/archopht.1980.01020040466014
Abstract

• Four patients with clinically localized lesions in the lateral medulla exhibited a tonic bias of their eyes toward the damaged side despite full extraocular movements. Each reported that his eyes were being pulled toward the involved side. Although the tonic bias was most prominent when fixation was inhibited, it also occurred with fixation and interfered with saccadic and smooth-pursuit eye movements. Saccades were hypometric when directed against the bias, whereas they were hypermetric when directed toward the side of the lesion. Smooth pursuit toward the intact side was severely impaired, whereas pursuit in the direction of the bias was normal or near normal. Lateropulsion of the eyes seems to be a unique sign of disease in the lateral medullary region of the brainstem.

References
1.
Wallenberg A:  Acuite bulbäraffection (Embolie der art. cerebellar post. inf. sinistr.?) . Arch Psychiatr Nervenkr 27:504-540, 1895.
2.
Goodhart SP, Davision C:  Syndrome of the posterior inferior and anterior inferior cerebellar arteries and their branches . Arch Neurol Psychiatr 35:501-524, 1936.Article
3.
Bjerver K, Silferskiöld BP:  Lateropulsion and imbalance in Wallenberg's syndrome . Acta Neurol Scand 44:91-100, 1968.Article
4.
Kommerell G, Hoyt WF:  Lateropulsion of saccadic eye movements . Arch Neurol 28:313-318, 1973.Article
5.
Hörnsten G:  Wallenberg's syndrome: II. Oculomotor and oculostatic disturbances . Acta Neurol Scand 40:447-468, 1964.
6.
Frisén L:  Lateropulsion of the eyes—a localizing brainstem sign . J Neurol 218:171-177, 1978.Article
7.
Baloh RW, Honrubia V, Sills A:  Eye-tracking and optokinetic nystagmus . Ann Otol 86:108-114, 1977.
8.
Daroff RB, Troost BT:  Supranuclear disorders of eye movements , in Duane TD (ed): Clinical Ophthalmology . New York, Harper & Row Publishers Inc, 1978, vol 2, chap 10, pp 3-4.
9.
Daroff RB:  Ocular motor manifestations of brainstem and cerebellar dysfunction , in Smith JL (ed): Neuro-ophthalmology . Hallandale, Fla, Huffman, 1970, vol 5, p 104.
10.
Zee DS, Yee RD, Cogan DG, et al:  Ocular motor abnormalities in hereditary cerebellar ataxia . Brain 99:207-234, 1976.Article
11.
Hagstrom L, Hörnsten G, Silfverskiöld BP:  Oculostatic and visual phenomena occurring in association with Wallenberg's syndrome . Acta Neurol Scand 45:568-582, 1969.Article
12.
Bird AC, Sanders MD:  Defects in supranuclear control of horizontal eye movements . Trans Ophthal Soc UK 90:417-432, 1970.
13.
Fisher CM, Karnes WE, Kubik CS:  Lateral medullary infarction—the pattern of vascular occlusion . J Neuropathol 20:323-379, 1969.Article
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