Vertical supranuclear gaze palsy in Niemann-Pick type C disease

Neurol Sci. 2012 Dec;33(6):1225-32. doi: 10.1007/s10072-012-1155-1. Epub 2012 Jul 19.


Vertical supranuclear gaze palsy (VSGP) is a key clinical feature in patients with Niemann-Pick type C disease (NP-C), a rare, autosomal recessive, neuro-visceral disorder caused by mutations in either the NPC1 or NPC2 gene. VSGP is present in approximately 65 % of the cases and is, with gelastic cataplexy, an important risk indicator for NP-C. VSGP in NP-C is characterized by a paralysis of vertical saccades, especially downward, with the slow vertical eye movement systems (smooth pursuit and the vestibulo-ocular reflex) spared in the early phase of the disease. This dissociation is caused by a selective vulnerability of the neurons in the rostral interstitial nuclei of the medial longitudinal fasciculus (riMLF) in NP-C. Here we discuss VSGP in NP-C and how clinicians can best elicit this sign.

Publication types

  • Review

MeSH terms

  • Animals
  • Brain / pathology
  • Brain / physiopathology
  • Eye Movements / physiology*
  • Humans
  • Nervous System Diseases / diagnosis
  • Nervous System Diseases / epidemiology
  • Nervous System Diseases / physiopathology
  • Niemann-Pick Disease, Type C / diagnosis*
  • Niemann-Pick Disease, Type C / epidemiology*
  • Niemann-Pick Disease, Type C / physiopathology
  • Supranuclear Palsy, Progressive / diagnosis*
  • Supranuclear Palsy, Progressive / epidemiology*
  • Supranuclear Palsy, Progressive / physiopathology