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Sustained downgaze mostly occurs in association with lesions affecting the dorsal midbrain. We report sustained downgaze in a patient with hepatic encephalopathy. The sustained downgaze existed for seven more days after she regained her consciousness. The persistent downgaze even after regaining full consciousness indicates localized pretectal dysfunction rather than diffuse encephalopathy as the mechanism of sustained downgaze in our patient. The ocular motor dysfunction in hepatic encephalopathy may be due to localized dysfunction of the brainstem. |
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brainstem,dysfunction brainstem,dysfunction,eye movement disorders with conjugate gaze,forced downward deviation of eyes downward gaze encephalopathy,metabolic gaze deviation globus pallidus,lesion of,bilateral hepatic encephalopathy hepatic encephalopathy, acute MRI,abnormal ocular motility,disorders of
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