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October 1959

The Spasticity of Conjugate Gaze Phenomenon

Author Affiliations

From the Howe Laboratory of Ophthalmology, Harvard University Medical School, Massachusetts Eye and Ear Infirmary. Special Trainee BT-357, National Institute of Neurological Diseases and Blindness (Dr. Smith), and Heed Fellow in Ophthalmology, Massachusetts Eye and Ear Infirmary (Dr. Gay). Present address of Dr. Smith is 900 Lenton Ave., Baltimore (12).

AMA Arch Ophthalmol. 1959;62(4):694-696. doi:10.1001/archopht.1959.04220040156022

Lateral conjugate deviation of the eyes on attempted forced closure of the lids was emphasized,1 in 1948, as a sign of value in the lateralization of cerebral lesions. This finding was termed "spasticity of conjugate gaze" and has also been referred to as the "perverse Bell's phenomenon."2 The deviation is characteristically to the side opposite the lesion (that is, to the side of hemiparesis and/or hemianopia). Such deviation was noted in only 3 of 156 persons with no known neurologic disease but was seen in 34 of 54 patients with unilateral cerebral disease. It was concluded that spasticity of conjugate gaze is of definite value in lateralizing the lesion. However, this phenomenon has not been analyzed from the point of view of localization within one hemisphere. The present study is an attempt to determine if this test may have localizing significance within one hemisphere, in addition to its

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