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