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NEUROLOGY 1989;39:385
© 1989 American Academy of Neurology

Ptosis and supranuclear downgaze paralysis

J. A. Büttner-Ennever, PhD, J. F. Acheson, MRCP, U. Büttner, MD, E. M. Graham, MRCP, FRCS, T.J.K. Leonard, MRCP, FRCS, M. D. Sanders, FRCP, FRCS and R. Ross Russell, FRCP

Institute of Neuropathology and Department of Neurology, Ludwig Maximilian University of Munich, Munich, FRG (Drs. Büttner-Ennever and Büttner)
Medical Eye Unit, St. Thomas' Hospital, London, UK. (Drs. Acheson, Graham, Leonard, Sanders, and Ross Russell)

A patient developed the unusual combination of a supranuclear downward gaze paralysis and bilateral ptosis. It was caused by a single midbrain glioma. Other ocular motor functions were intact. The neuropathologic examination showed a tumor growing mainly around the third ventricle and the aqueduct. The findings agree with recent experimental evidence that a network of neural elements involved in eyelid control lies in the supraoculomotor area immediately dorsal to the oculomotor nucleus.

Address correspondence and reprint requests to Dr. Büttner-Ennever, c/o Inst. Physiology, Pettenkoferstr. 12, D-8000 Munich 2, FRG.

Supported by the German Research Council SFB 220/D7/D8.

Received July 28, 1988. Accepted for publication in final form September 20, 1988.






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