Bilateral horizontal gaze paralysis due to pontine hemorrhage

Summary In a case of bilateral horizontal gaze paralysis, vertical gaze was clinically intact but eye movement recordings demonstrated a transient reduction of vertical saccadic velocities. Horizontal caloric vestibulo-ocular responses were absent. CT scanning and NMR imaging showed a hematoma in the median pontine tegmentum. This case provides additional evidence that vertical and horizontal saccade genesis may be independent of caudal paramedian pontine reticular formation lesions.