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Vertical Head Thrusting in Acquired Supranuclear Vertical Ophthalmoplegia

Lee, Yeon-Hee MD; Jeong, Seong-Hae MD; Kim, Hyo-Jung PhD; Hwang, Jeong-Min MD, PhD; Lee, Woohyuk MD; Kim, Ji-Soo MD, PhD

doi: 10.1097/WNO.0000000000000506
Original Contribution

Abstract: Patients with congenital ocular motor apraxia (OMA) typically show head thrusts while attempting to shift gaze. In congenital OMA, this compensatory head motion mostly occurs in the horizontal plane. Two patients with acquired palsy of voluntary vertical gaze and continuous upward gaze deviation, one from aortic surgery and the other from multiple infarctions involving the mesodiencephalic junction, showed intermittent downward head thrusting to redirect the eyes straight ahead or downward. The head thrusting behavior improved markedly after surgical correction of the upward gaze deviation in one patient. Vertical head thrusting may be a characteristic sign of acquired vertical gaze palsy when combined with vertical gaze deviation.

Departments of Ophthalmology (Y-HL, WL) and Neurology (S-HJ), Chungnam National University College of Medicine, Daejeon, Korea

Research Administration Team, Seoul National University Bundang Hospital (H-JK), Seongnam, Korea

Departments of Ophthalmology (J-MH) and Neurology (J-SK), Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

Address correspondence to Ji-Soo Kim, MD, PhD, Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, Korea; E-mail:

The authors report no conflicts of interest

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© 2017 by North American Neuro-Ophthalmology Society