An unusual variant of the dorsal midbrain syndrome in MS: Clinical characteristics and pathopysiologic mechanisms

Elliot Frohman, Richard B Dewey, Teresa C. Frohman

Research output: Contribution to journalReview article

14 Scopus citations


Patients with MS exhibit a broad diversity of ocular motor syndromes. We describe a patient with relapsing-remitting MS who developed an unusual variation of the dorsal midbrain syndrome, characterized by monocular convergent-retraction nystagmus in the right eye, accompanied by divergent-retraction nystagmus in the fellow eye upon attempted upward gaze. Examination also revealed a skew deviation with a left hyperdeviation and severe adduction limitation in the left eye during attempted rightgaze. We propose that a left INO accounted for the inability of the left eye to adduct (and result in convergent-retraction) during attempted upward saccades. We consider the pathophysiologic mechanisms responsible for our observations and review important details of the dorsal midbrain ocular motor circuitry.

Original languageEnglish (US)
Pages (from-to)322-325
Number of pages4
JournalMultiple Sclerosis
Issue number3
StatePublished - Jun 1 2004



  • Convergent retraction nystagmus
  • Dorsal midbrain
  • Skew deviation

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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