BILATERAL PTOSIS AND UPGAZE PALSY WITH RIGHT HEMISPHERIC LESIONS

Bilateral ptosis is reported with unilateral hemispheric lesions, sugg esting partial lateralization of the control of the levator palpebrae superioris. There is a tight synkinesis between vertical eye and eyeli d movements, but a similar, lateralized control of vertical gaze has n ot been previously described. We report 3 patients with right hemisphe ric infarctions, in whom bilateral ptosis was accompanied by impaired upward gaze. We postulate that this lateralization of ocular motor fun ction reflects the special contribution that the nondominant hemispher e makes to attention.