Supranuclear Vertical Gaze Palsy in Movement Disorders

Vertical gaze palsy, a neurological impairment affecting the upward and downward movement of the eyes, can be caused by various disorders. Understanding this phenomenon is essential for accurate diagnosis and effective management. This review aims to present a practical overview of vertical gaze palsy, its manifestation in various movement disorders, and the clinical relevance of such impairments. We did a thorough non-systematic search of the literature in PubMed with various keywords such as 'gaze palsy', 'vertical gaze palsy', 'gaze abnormality', and 'eye movement disorder'. Vertical gaze palsy can manifest in various disorders such as Parkinson's disease, atypical Parkinsonian syndromes, Niemann-Pick disease type C, Wilson's disease, Whipple's disease, prion disease, and several others. This comprehensive review elucidates the spectrum of movement disorders linked to vertical gaze palsy, exploring the specific ways it manifests and the complexities in diagnosing the condition. The list of movement disorders causing vertical gaze palsy is extremely wide, encompassing neurodegenerative, metabolic, infectious, autoimmune disorders, and intoxication with certain substances and specific medications. The differential diagnosis consists of various etiologies with heterogeneous presentations that may overlap and mimic each other. We hope that this paper will assist practitioners in managing the complex process of diagnosing a patient with vertical gaze palsy.