Acquired Oculomotor Apraxia


a.k.a. Roth-Bielschowsky syndrome (supranuclear palsy of gaze due to corticotectal/corticotegmental tract lesions)


A form of supranuclear palsy diagnosed clinically and by isolating the underlying cause

Clinical features:

Inability to perform horizontal saccades
Vertical eye movements may be intact
Oculocephalic reflexes are intact
Caloric testing shows slow deviation without saccades
Optokinetic nystagmus remains without saccades
+/-dementia +/-pseudobulbar palsy

Findings on Investigations:

MRI: evidence of severe bilateral cerebrovascular disease (bifrontal or bilateral anterior internal capsule) or suggests a cause of dementia
If congenital this is called Cogan oculomotor apraxia syndrome

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