Bilateral ptosis and gaze paresis due to unilateral thalamic lesions

Abstract

In this report, we present three cases of bilateral ptosis associated with vertical and/or horizontal gaze paresis due to unilateral thalamic lesions. As far as we know, there is only one earlier report of bilateral ptosis due to an isolated thalamic lesion. In the light of our cases, we propose that cortical efferent pathways, known as supranuclear pathways, descend from supranuclear centers to diencephalic centers which serve eye opening. In addition, vertical and horizontal gaze may be affected by these thalamic lesions.