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Conjugate gaze abnormalities

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The normal movements of the eyes occur in an organised fashion so that the visual axes remain in the same plane throughout eye movements.

The centres for conjugate gaze are the frontal lobe for saccadic movements and in the occipital lobe for pursuit movements. The conjugate movements to the right are controlled from the left side of the brain and vice-versa. Fibres travel from these centres to the region of the sixth nerve nucleus from which area the medial longitudinal fasciculus coordinates contraction with the third nerve and thence the medial rectus.

In a brainstem lesion there is ipsilateral paralysis of horizontal conjugate gaze and a frontal lobe lesion causes contralateral paralysis of horizontal conjugate gaze.

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