Brain control of conjugate horizontal and vertical eye movements: a survey of the structural and functional correlates

Brain : a Journal of Neurology
M B Bender

Abstract

(1) It appears that all oculomotor pathways originating within the cerebrum and mediating stimulations and lesions, project from the two sides of the brain through the diencephalon to the brain-stem. (2) The pathways subserving horizontal movements decussate at the level of the oculomotor and trochlear nuclei, across the midsagittal plane. The direction of vector action within the brain above the 'electroanatomical' oculomotor decussation is predominately contraversive; below this levelit is ipsiversive. (3) The pontine reticular formation, the abducens and oculomotor nuclei and the median longitudinal fasciculus play an important role in the physiology of ipsilateral conjugate gaze. A 1 mm lesion within the paramedian pontine reticular formation causes paralysis of ipsilateral conjugate gaze, while a 1 mm lesion within the median longitudinal fasciculus causes impairment of contralateral (disconjugate) gaze with paralysis of adduction of the ipsilateral eye and nystagmus in the contralateral or abducting eye. (4) True binocular vertical movements occur only when both sides of the brain are activated either directly or through bilateral sensory (visual or vestibular) inputs. Vertical and oblique monocular movements can be elici...Continue Reading

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