Horizontal Gaze and Syndromes of the Pons

covers deviations and disorders of horizontal gaze, which are so significantly linked to lesions of the pons that an emphasis on pontine signs is an important focus of this chapter. The pontine syndromes presented include a congenital case of horizontal gaze palsy and progressive scoliosis, and syndromes associated with adjacent tegmental structures, especially the paramedian reticular formation, the facial nerve, and the medial longitudinal fasciculus. A lesion of the medial longitudinal fasciculus causes internuclear ophthalmoplegia Examples are provided of internuclear ophthalmoplegia in childhood, combined unilateral conjugate gaze palsy and internuclear ophthalmoplegia, the one-and-a-half syndrome, and other variants. A case of bilateral horizontal gaze palsy permits discussion of the caloric test, one of the most widely used clinical test of the vestibulo-ocular reflex.