Abstract
The clinical and pathologic findings in 27 patients with paralysis of vertical gaze were studied and compared with 34 patients in whom there were lesions in similar locations but without vertical gaze paralysis. Upward gaze paralysis occurred mainly with bilateral lesions involving the pretectum, posterior commissure, or dorsal midbrain tegmentum. Unilateral lesions caused paralysis of upward gaze only when the posterior commissure was involved. Bilateral lesions of the tegmentum of the rostral and midpons also caused paralysis of upward gaze and in some cases paralysis of downward gaze as well. Paralysis of downward gaze also resulted from bilateral involvement in the prerubral region of the diencephalon and midbrain.