The occurrence of isolated and complex patterns of extraocular muscle palsy in various postinfectious disease syndromes has been well documented.
The supranuclear gaze palsies are of special interest to neurology and neuro-ophthalmology because of the implied diagnostic differential with respect of tumors, vascular lesions, a variety of specific and nonspecific inflammatory disorders (virus infections, lupus erythematosus, periarteritis, etc.), and the various demyelinating diseases.1
It seems worthwhile, therefore, to report a case of downward gaze palsy following an apparent mumps encephalomyelitis and to discuss some of the modern concepts of vertical gaze control.
Report of Case
The patient is a 5-year-old boy with a history of normal growth and development. At age 1½ years a diagnosis of mumps was made on the basis of unilateral parotid swelling and febrile illness lasting about one week. A few days afterwards it was noted that he walked with his head tilted down and