Supranuclear Disorders



The ocular motor network is controlled by supranuclear centres that help coordinate all ocular motility, including saccades, pursuit, vergence and vestibular movements. This control may be disrupted in congenital or acquired disorders that lead to characteristic syndromes that are described in this chapter.


Supranuclear Parinauds Dorsal midbrain Internuclear ophthalmoplegia Ocular tilt reaction Skew deviation 

Supplementary material

Video 8.3

A wheelchair bound patient with a right exotropia that alternates freely on a cover test. On Dextroversion there is limitation of left adduction and ataxic nystagmus of the right eye. On levoversion, there is limitation of left adduction and ataxic nystagmus of the left eye, suggestive of bilateral wall eyed internuclear ophthalmoplegia

Video 8.10

A 25 year old woman with complaints of episodic oscillopsia. On switching on the slit lamp beam, the right eye exhibits bursts of spasmodic, involuntary intorsion with intermittent depression of the eye


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Royal Free London NHS Foundation TrustLondonUK

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