Sustained downgaze deviation Two cases without structural pretectal lesions

Article abstract — Severe conjugate downward eye deviation of several days9 duration in a lethargic patient with subarachnoid hemorrhage and of several weeks9 duration in a comatose patient with hypoxic encephalopathy occurred in the absence of structural pretectal lesions. Persisting downgaze in a stuporous or comatose patient does not necessarily indicate anatomic pretectal damage.