A 52-year-old man presented with sudden onset of vertical diplopia, limited vertical gaze (figure 1), vertical oscillopsia, taste changes and lip numbness. His family had noted left-sided facial changes, with flattening of the nasolabial fold (figure 2). He had no significant medical or family history. He worked as a bus driver, drank 21 units of alcohol per week and had a smoking history of 9 pack-year. Figure 1 Limitation of vertical gaze. Figure 2 Left facial nerve palsy. On examination, there was subtle unilateral upper motor neurone facial weakness. He had normal visual acuity, colour vision, visual fields and fundus examination. Eye movement examination showed completely absent voluntary up and down gaze, both saccadic and pursuit, with some vertical gaze on the doll’s head manoeuvre. Pupil examination identified loss of pupillary contraction to light with …

中文翻译：

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背侧中脑（Parinaud）综合征

一名 52 岁男性突然出现垂直复视、垂直凝视受限（图 1）、垂直振动、味觉改变和嘴唇麻木。他的家人注意到左侧面部发生变化，鼻唇沟变平（图 2）。他没有重要的病史或家族史。他是一名公共汽车司机，每周饮酒 21 单位，并且有 9 包年的吸烟史。图 1 垂直注视的限制。图 2 左侧面神经麻痹。检查时，有轻微的单侧上运动神经元面部无力。他的视力、色觉、视野和眼底检查正常。眼球运动检查显示完全没有自主的上下注视，包括扫视和追逐，在娃娃头部动作时有一些垂直注视。