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Isolated or Predominant Ocular Motor Nerve Palsy as a Manifestation of Brain Stem Stroke Stroke 24:581-586, Kim,J.S.,et al, 1993 See this aricle in Pubmed Article Abstract Five patients had small strokes in the area of oculomotor nuclei or fascicles and showed various combinations of oculomotor disturbances.Three of these patients showed vertical gaze paresis of the opposite eye.One patient with a small hemorrhage near the aqueduct of Sylvius showed fourth nerve palsy on the contralateral side,and a patient with a small infarct in the pontine tegmentum showed isolated sixth nerve palsy.Nonocular minor neurological signs included trigeminal sensory changes in four patients and clumsy are in two.Ocular and monocular dysfunctions generally improved within several months.Radiological findings of the brain stem correlated well with the ocular signs.We conclude that acute brain stem stroke should be included in the differential diagnosis of isolated ocular motor nerve palsy and that appropriate diagnostic investigations should be performed in these cases.

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