Incorrect

Correct! This patient has impaired volitional gaze--saccades and pursuit--in the horizontal and vertical planes. Volitional gaze in the vertical plane is virtually absent. Yet passive movement of her head (the doll’s eye or oculocephalic maneuver) elicits vertical eye movements of reasonable amplitude, indicating that the vestibulo-ocular reflex is intact. These features tell you that the gaze disturbance spares the pathway from the vestibular end organs to the ocular motor nuclei. The lesion must therefore lie above these ocular motor nuclei in the hierarchy of ocular motor control. Such a disturbance is termed “supranuclear.” Other clinical features—reduced spontaneous facial movements and gestures, axial rigidity, and frequent unexplained falls—are also likely to be present in such cases, defining a condition known as “progressive supranuclear palsy,” a degenerative disorder for which there is sadly no effective treatment. Precautions against falling and aspiration must be taken.

Incorrect