Salari Mehri, Alikhani Alireza, Hojjati Pour Fatemeh, Etemadifar Masoud
Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shohada Tajrish Hospital, Tehran, Iran.
Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Neuroophthalmology. 2024 Jul 17;49(1):17-34. doi: 10.1080/01658107.2024.2379423. eCollection 2025.
Vertical gaze palsy, a neurological impairment affecting the upward and downward movement of the eyes, can be caused by various disorders. Understanding this phenomenon is essential for accurate diagnosis and effective management. This review aims to present a practical overview of vertical gaze palsy, its manifestation in various movement disorders, and the clinical relevance of such impairments. We did a thorough non-systematic search of the literature in PubMed with various keywords such as 'gaze palsy', 'vertical gaze palsy', 'gaze abnormality', and 'eye movement disorder'. Vertical gaze palsy can manifest in various disorders such as Parkinson's disease, atypical Parkinsonian syndromes, Niemann-Pick disease type C, Wilson's disease, Whipple's disease, prion disease, and several others. This comprehensive review elucidates the spectrum of movement disorders linked to vertical gaze palsy, exploring the specific ways it manifests and the complexities in diagnosing the condition. The list of movement disorders causing vertical gaze palsy is extremely wide, encompassing neurodegenerative, metabolic, infectious, autoimmune disorders, and intoxication with certain substances and specific medications. The differential diagnosis consists of various etiologies with heterogeneous presentations that may overlap and mimic each other. We hope that this paper will assist practitioners in managing the complex process of diagnosing a patient with vertical gaze palsy.
垂直性凝视麻痹是一种影响眼球上下运动的神经功能障碍，可由多种疾病引起。了解这一现象对于准确诊断和有效治疗至关重要。本综述旨在对垂直性凝视麻痹、其在各种运动障碍中的表现以及此类功能障碍的临床相关性进行实用概述。我们在PubMed上使用“凝视麻痹”、“垂直性凝视麻痹”、“凝视异常”和“眼球运动障碍”等各种关键词对文献进行了全面的非系统性检索。垂直性凝视麻痹可出现在多种疾病中，如帕金森病、非典型帕金森综合征、C型尼曼-匹克病、威尔逊病、惠普尔病、朊病毒病等。这篇全面的综述阐明了与垂直性凝视麻痹相关的运动障碍范围，探讨了其具体表现方式以及诊断该病的复杂性。导致垂直性凝视麻痹的运动障碍种类繁多，包括神经退行性疾病、代谢性疾病、感染性疾病、自身免疫性疾病以及某些物质和特定药物中毒。鉴别诊断包括各种病因，其表现各异，可能相互重叠且相互模仿。我们希望本文能帮助从业者处理诊断垂直性凝视麻痹患者这一复杂过程。
