Selective paralysis of downward gaze is known to be rare. There are 6
cases reported in the literature based on neuropathologic and anatomic
al studies, We report a 60-year-old diabetic and hypertensive patient
with isolated down gaze palsy, Computed tomography failed to show the
lesion in the periaqueductal region, and the diagnosis was made by Mag
netic resonance imaging, The case presented is the only one still surv
iving.