Abstract

In three patients with Fisher syndrome abnormal eye movements suggested the presence of supranuclear lesions.The first patient was a 59-year-old woman, and the second patient was a 37-year-old man. Both patients had preservation of Bell's phenomenon despite paralysis of voluntary upward gaze, an increase of the range of supraduction in the doll's eye maneuver, and downward nystagmus on gaze and positioning tests. In addition, ocular dysmetria was observed in the first and rebound nystagmus in the second patient. The third patient, a 56-year-old man, show ocular dysmetria and square wave jerks.In our patients, no central lesion was detected by either CT or MRI studies, although the abnormal eye movements mentioned above are consistent with a supranuclear lesion. These findings can't show definite location of the lesion in Fisher syndrome. However, ophthalmoplegia might result from both the peripheral and the supranuclear lesions.

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