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Upward Gaze

Topic: Anatomy

Created on Sunday, February 1 2009 by dr. no

Last modified on Sunday, February 1 2009.

A 72 year old man presents with a month history of progressive difficulty in upward gaze and was found on exam mid-dilated mildly reactive pupils, and convergence-retraction nystagmus. Where is the lesion?

 
        A) Dominant parietal lobe
 
        B) Thalamus
 
        C) Midbrain tectal region
 
        D) Lower Pons
 
        E) Non-dominant parietal lobe
 

 


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This question was created on February 01, 2009 by dr. no.
This question was last modified on February 01, 2009.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) Dominant parietal lobe

This answer is incorrect.


A lesion producing these findings occurs in the midbrain tectal region. It usually occurs by extra-axial compression on the quadrigeminal plate. These findings are consistent with Parinaud's syndrome  (See References)

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B) Thalamus

This answer is incorrect.


A lesion producing these findings occurs in the midbrain tectal region. It usually occurs by extra-axial compression on the quadrigeminal plate. These findings are consistent with Parinaud's syndrome  (See References)

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C) Midbrain tectal region

This answer is correct.


A lesion producing these findings occurs in the midbrain tectal region. It usually occurs by extra-axial compression on the quadrigeminal plate. These findings are consistent with Parinaud's syndrome  (See References)

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D) Lower Pons

This answer is incorrect.


A lesion producing these findings occurs in the midbrain tectal region. It usually occurs by extra-axial compression on the quadrigeminal plate. These findings are consistent with Parinaud's syndrome  (See References)

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E) Non-dominant parietal lobe

This answer is incorrect.


A lesion producing these findings occurs in the midbrain tectal region. It usually occurs by extra-axial compression on the quadrigeminal plate. These findings are consistent with Parinaud's syndrome  (See References)

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References:

1. Leigh, R.J., and Zee, D.S. (2006). The Neurology of Eye Movements, 4th Edition. Oxford University Press, Oxford. (ISBN:0195300904)Advertising:
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anatomy
Upward Gaze
Question ID: 020109085
Question written by dr. no. (C) FrontalCortex.com 2006-2009, all rights reserved. Created: 02/01/2009
Modified: 02/01/2009
Estimated Permutations: 120

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