A Case of Bilateral Horizontal Gaze Palsy due to Pontine Hemorrhage

ABSTRACT

PURPOSE: To report a case of bilateral horizontal gaze palsy associated with pontine hemorrhage. METHODS: A 51-year-old man developed a sudden decrease in consciousness. Computed tomography reveal a pontine hemorrhage and infarctions of both basal ganglia. The mentality was recovered after conservative treatment, but he complained of difficulty in moving his eyes. We performed ophthalmic and radiologic evaluations to confirm a diagnosis of bilateral horizontal gaze palsy and to reveal the condition. RESULTS: On ophthalmic examination, his eye showed complete bilateral horizontal gaze palsy, but convergence and vertical eye movements were normal. Radiologic evaluation revealed a pontine hemorrhage, and the hemorrhagic area was consistent the bilateral paramedian pontine reticular formation (PPRF).