Unilateral Medial Thalamic Infarct and Isolated Vertical Gaze Palsy- Case Report

Structures controlling the vertical gaze are located in the mesencephalon. However, data about supranuclear control of this field is insufficient. 29-year-old female patient has admitted to our clinic for diplopia. Neurological examination was in normal limits except skew deviation and vertical gaze paresis. MRI showed isolated infarct on mediodorsal nucleus of right thalamus. Lesion had no extension to mesencephalon. This case, in clinical and anatomical correlation, suggests that a group of corticofugal fibers providing the supranuclear control of vertical gaze, reach to mesencephalon, by passing the dorsomedial nucleus of the thalamus.