Frontal lobe lesions |
Defect in generating voluntary saccades |
Transient ipsilateral horizontal gaze deviation acutely |
Gaze palsy overcome with the oculocephalic (doll's eye) maneuver or caloric stimulation |
Epileptogenic lesions in the frontal eye fields |
Transient deviation of the eyes and head to the contralateral side |
Head and eye movements toward the same side during a seizure |
Unilateral parietal lesions |
Unilateral or bilateral increased saccade latencies |
Hypometria (shortened range) for contralateral saccades |
Saccadic slowing |
Bilateral parietal lesions |
Acquired ocular motor apraxia (inability to generate voluntary movements) |
Lesions in the corona radiata adjacent to the genu of the internal capsule |
Contralateral selective saccadic palsy |
Hemorrhages deep in a cerebral hemisphere, particularly the thalamus |
Eye deviation to the side of the hemiparesis ("wrong-way eyes") |
Mesencephalic lesions |
Paresis of contralateral saccades |
Supranuclear contralateral gaze palsies associated with ipsilateral oculomotor palsies |
Pontine lesions affecting the abducens nucleus and/or the PPRF |
Ipsilateral conjugate gaze palsy |
Doll's eye maneuver or cold caloric stimulation usually does not overcome gaze palsy |
Bilateral horizontal gaze palsies with bilateral lesions |