Psychiatric Manifestation & Vertical Gaze Palsy: Causes & Reasons

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Patient File

Sex unknown, Age unknown

Reported Symptoms

Psychiatric Manifestation, Vertical Gaze Palsy,

Negated

None

Unsure

None

Possible Causes

Primary Progressive Multiple Sclerosis

We present three patients with a clinical course and cerebrospinal fluid findings consistent with a diagnosis of primary progressive multiple sclerosis (PPMS). Extensive and repeated magnetic resonance imaging (MRI) examinations showed only diffuse abnormality in brain and spinal cord, but no focal lesions. We propose[…] [ncbi.nlm.nih.gov]

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Multiple Sclerosis

Psychiatric manifestations of multiple sclerosis: A review. Can J Psychiatry 1996 ; 41: 441 – 445. Google Scholar SAGE Journals ISI 5. Patten, SB, Svenson, LW, Metz, LM. [dx.doi.org]

Fatigue and psychiatric symptoms, such as depression or euphoria, can also be manifestations of MS. Symptoms (attacks) of MS need disseminated in “time and space.” [clinicaladvisor.com]

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Huntington Disease

Huntington's disease (HD) is an autosomal dominant and progressive neurodegenerative syndrome characterized by motor, cognitive and psychiatric manifestations. [ncbi.nlm.nih.gov]

Although noncompliance to oral antipsychotic drugs can be a practical problem, especially when significant psychiatric manifestations of HD are present, the effect of depot [ncbi.nlm.nih.gov]

To our knowledge, this is the first case report on combat related PTSD as psychiatric disorder manifested prior to HD. [ncbi.nlm.nih.gov]

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Neurologic Manifestation of Whipple Disease

myelopathy, ataxia and psychiatric manifestations. [ncbi.nlm.nih.gov]

In our case after the confirmation of possible CNS WD (fever of unknown origin, chronic migratory arthralgias, unexplained lymphadenopathy, supranuclear vertical gaze palsy [benthamopen.com]

Patients with central nervous system (CNS) involvement may present in a variety of ways, including cognitive impairment, psychiatric manifestations, gaze palsies, upper motor [link.springer.com]

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Neurotic Disorder

Individuals have been described in the medical literature with other psychiatric manifestations such as obsessive-compulsive disorder, bipolar disorders, and hallucinations [rarediseases.org]

Vertical gaze palsy (the inability to move the eyes up and down), enlarged liver, enlarged spleen, or jaundice in young children are strong indications that NPC should be [nnpdf.org]

Vertical supranuclear gaze palsy may be present. [patient.info]

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Anxiety Disorder

Psychiatric manifestations may remain isolated for several years. [dx.doi.org]

Alongside psychiatric disorders, patients develop early motor signs: ataxia, abnormal movements and, an almost consistent finding, vertical supranuclear gaze palsy. [ncbi.nlm.nih.gov]

This review focuses on neurologic and psychiatric manifestations implicated with gluten sensitivity, reviews the emergence of gluten sensitivity distinct from celiac disease [dx.doi.org]

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Whipple Disease

Patients with central nervous system (CNS) involvement may present in a variety of ways, including cognitive impairment, psychiatric manifestations, gaze palsies, upper motor [link.springer.com]

We describe a patient with cerebral Whipple disease who presented with changes in mental status, confusion, inverse sleep-wake cycle, bilateral ptosis and vertical gaze palsy [ncbi.nlm.nih.gov]

Patients may present in a variety of ways, including cognitive impairment, psychiatric manifestations, gaze palsies, upper motor neurone signs and hypothalamic dysfunction [jmedicalcasereports.com]

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Niemann-Pick Disease Type C

NP-C is characterised by visceral, neurological and psychiatric manifestations that are not specific to the disease and that can be found in other conditions. [ncbi.nlm.nih.gov]

The second developed progressive ataxia, accompanied by a vertical gaze palsy, when she was 13. [ncbi.nlm.nih.gov]

manifestations. [ncbi.nlm.nih.gov]

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Mental Disorder

Psychiatric manifestations may remain isolated for several years. [dx.doi.org]

Alongside psychiatric disorders, patients develop early motor signs: ataxia, abnormal movements and, an almost consistent finding, vertical supranuclear gaze palsy. [ncbi.nlm.nih.gov]

Most notably, vertical supranuclear gaze palsy (VSGP) – particularly paresis of downgaze – is a highly specific and highly prevalent sign that may be present at an early stage [dx.doi.org]

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Psychosis

According to the literature, this psychiatric manifestation resolves within 2 weeks of discontinuing the offending agent. [ncbi.nlm.nih.gov]

Most notably, vertical supranuclear gaze palsy (VSGP) – particularly paresis of downgaze – is a highly specific and highly prevalent sign that may be present at an early stage [doi.org]

There is growing evidence that a proportion of psychosis/ psychiatric manifestations in children may be immunemediated, and physicians should consider this etiology in each [ncbi.nlm.nih.gov]

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Suprasellar Tumor

Psychiatric manifestations as initial presentation for pediatric CNS germ cell tumors, a case series. Childs Nerv Syst 32 (8): 1359-62, 2016. [cancer.gov]

This phenomenon is caused by involvement of midbrain structures adjacent to the pineal GCT and is characterised by vertical gaze palsy, nystagmus on convergence and pupillary [tandfonline.com]

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Tourette Syndrome

Trial Registration clinicaltrials.gov Identifier: NCT00139308 Tourette syndrome (TS) is characterized by motor and vocal tics associated with various psychiatric manifestations [dx.doi.org]

The neurological examination revealed vertical gaze palsy with preserved vertical oculocephalic movements. [ncbi.nlm.nih.gov]

manifestations that affect social and professional life. 1 Severe forms of the disease respond poorly to medical treatment, which has potentially serious side effects. 2 [dx.doi.org]

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Boxer's Dementia

Examination shortly before death revealed hypomimia, dysarthria, vertical supranuclear gaze palsy and impaired postural reflexes. [actaneurocomms.biomedcentral.com]

[…] involving the brain stem, basal ganglia and cerebellum with vertical gaze and pseudobulbar palsy, nuchal dystonia and dementia. [actaneurocomms.biomedcentral.com]

PSP presents classically with postural instability and falls, slurred speech, a vertical supranuclear gaze palsy and a dysexecutive syndrome[ 12 ], but there are a number [actaneurocomms.biomedcentral.com]

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Sellar Tumor with Suprasellar Extension

Psychiatric [ edit ] Various psychiatric manifestations have been associated with pituitary disorders including pituitary adenomas. [en.wikipedia.org]

Psychiatric manifestations may include depression, anxiety, easy irritability and emotional instability. It may also result in various cognitive difficulties. [en.wikipedia.org]

Psychiatric symptoms such as depression, anxiety [10] apathy, emotional instability, easy irritability and hostility have been noted. [11] Complications [ edit ] Acromegaly [en.wikipedia.org]

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Olfactory Groove Meningioma

Most common symptoms are anosmia, headaches, and visual disturbances, but a range of manifestations, both neurologic and psychiatric, has been described in a significant number [symptoma.com]

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Niemann-Pick Disease

Other features presenting later in life may include dystonia and vertical supranuclear gaze palsy, dementia and psychiatric manifestations. [genedx.com]

Examination showed ataxia, moderate cognitive impairment, and vertical gaze palsy. EEG revealed diffuse slowing and disorganization of background rhythms. [ncbi.nlm.nih.gov]

Individuals have been described in the medical literature with other psychiatric manifestations such as obsessive-compulsive disorder, bipolar disorders, and hallucinations [rarediseases.org]

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Colloid Cyst of the Third Ventricle

Neuropsychiatric Manifestations of Colloid Cysts: a review of the literature. Psychiatr Danub. 2015 Sep. 27 Suppl 1:S315-20. [Medline]. [emedicine.medscape.com]

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Neurocysticercosis

In this communication we describe an interesting case of multiple neurocysticercosis in a young presenting with psychiatric manifestations. [ncbi.nlm.nih.gov]

A sign of worsening hydrocephalus is vertical gaze palsy, the inability to gaze upward or downward when asked. The head of Mr. [americannursetoday.com]

“Psychiatric Manifestations of Neurocysticercosis: A Study of 38 Patients from a Neurology Clinic in Brazil,” Journal of Neurology, Neurosurgery & Psychiatry, Vol. 62, [scirp.org]

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Myasthenia Gravis

Psychiatric manifestations in systemic lupus erythematosus. Autoimmun Rev. 2007;6:421–6. [doi.org]

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Lead Encephalopathy

Neurologic and psychiatric manifestations of lead poisoning in adults (case report and review of the literature) [in German]. [ajnr.org]

HIV encephalopathy ( HIV-related encephalopathy ) a progressive primary encephalopathy caused by infection with human immunodeficiency virus type I, manifested by a variety [medical-dictionary.thefreedictionary.com]

Fortschr Neurol Psychiatr 1991 ; 59 : 413 –24 Tuzun M, Tuzun D, Salan A, et al. Lead encephalopathy: CT and MR findings. [ajnr.org]

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Pineal Gland Dysfunction

It is very likely that the pineal plays a significant role in the manifestation of several mental illnesses. [thebridgelifeinthemix.info]

[…] eye movements Problems with the visual pathways in pineal tumors: Accommodation deficiency Oculomotor nerve palsy Failure of downward gaze Visual field disturbance (mass [pedsoncologyeducation.com]

Currently, much interest is focused on the role that melatonin may play in various psychiatric disorders, and pineal research now represents one of the active areas of current [thebridgelifeinthemix.info]

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Creutzfeldt Jakob Disease

The disease usually presents in middle age, but one case of CJD in a 2 year old child was reported from Bombay. [8] Younger patients presenting with early psychiatric and [neurologyindia.com]

[…] behavioural manifestations have been reported from United Kingdom since 1994 and recently from some other European countries. [9], [10], [11] They subsequently developed cerebellar [neurologyindia.com]

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Rubinstein-Taybi Syndrome

These manifestations consist of epilepsy, intellectual disability, and neurobehavioral and psychiatric problems, including autism spectrum disorder. [docksci.com]

These lesions are associated with different neurological manifestations that are frequently associated with TSC. [docksci.com]

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Kernicterus

HIV encephalopathy, HIV-related encephalopathy AIDS encephalopathy; a progressive primary encephalopathy caused by human immunodeficiency virus type 1 infection, manifested [medical-dictionary.thefreedictionary.com]

[…] encephalopathy a condition, usually occurring secondary to advanced liver disease, marked by disturbances of consciousness that may progress to deep coma (hepatic coma), psychiatric [medical-dictionary.thefreedictionary.com]

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Botulism

Consequently, many of these patients were hospitalized with a range of other neurologic and psychiatric diagnoses. [web.archive.org]

Because cases were widely dispersed and initially involved atypical manifestations of acute botulism, many practitioners and specialists were misled in their primary diagnosis [web.archive.org]

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Posterior Cerebral Artery Occlusion with Infarction

Fortschr Neurol Psychiatr 1987;55:37–53. [karger.com]

Coma with vertical gaze palsy: relevance of angio-CT in acute Percheron artery syndrome. Case Rep Neurol, 2 (2010), pp. 74-79 [7] L. Rivera-Lara, N. Henninger. [elsevier.es]

gaze palsy, lid retraction, pupillary light-near dissociation, convergence-retraction nystagmus Thalamic syndromes [11] Decreased arousal Variable sensory loss Aphasia Visual [amboss.com]

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Niemann-Pick Disease Type B

Individuals have been described in the medical literature with other psychiatric manifestations such as obsessive-compulsive disorder, bipolar disorders, and hallucinations [rarediseases.org]

[…] supranuclear gaze palsy (VSPG), dysarthria, dysphagia, dystonia, seizures, gelastic cataplexy, and psychiatric disorders. [orpha.net]

Vertical gaze palsy (the inability to move the eyes up and down), enlarged liver, enlarged spleen, or jaundice in young children are strong indications that NPC should be [nnpdf.org]

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Pseudobulbar Palsy

Find the answers you need on the hottest topics in neurology, including involuntary movement disorders; single gene mutations with neuropsychiatric manifestations; psychiatric [books.google.com]

vertical gaze and pseudobulbar palsy, nuchal dystonia and dementia. ( 24963673 ) Steele J.C....Olszewski J. 2014 8 Pseudobulbar paralysis in the Renaissance: Cosimo I de' [malacards.org]

Progressive supranuclear palsy: a heterogeneous degeneration involving the brain stem, basal ganglia and cerebellum with vertical gaze and pseudobulbar palsy, nuchal dystonia [dovemed.com]

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Niemann-Pick Disease Type C1

Individuals have been described in the medical literature with other psychiatric manifestations such as obsessive-compulsive disorder, bipolar disorders, and hallucinations [rarediseases.org]

[…] supranuclear gaze palsy (VSPG), dysarthria, dysphagia, dystonia, seizures, gelastic cataplexy, and psychiatric disorders. [orpha.net]

Supranuclear Gaze Palsy) Unsteadiness of gait, clumsiness, problems in walking (ataxia) Difficulty in posturing of limbs (dystonia) Slurred, irregular speech (dysarthria) [npuk.org]

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Paraneoplastic Neurologic Syndrome

Keywords Paraneoplastic neurological syndromes, onconeuronal antibodies, ion channel antibodies, surface antibodies, psychiatric manifestations, limbic encephalitis, therapy [touchneurology.com]

To identify an autoreactivity in a 66-year-old woman who presented with combined brainstem and cerebellar syndrome including vertical gaze palsy, severe progressive ataxia [ncbi.nlm.nih.gov]

manifestations, seizures, dyskinesias, dystonia, and autonomic instability. [questdiagnostics.com]

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