Supranuclear paralysis of monocular elevation.

A man with bronchogenic carcinoma lost the ability to elevate his left eye voluntarily. His eyes were level in the primary position and the Bell phenomenon was normal, indicating that the ophthalmoplegia was caused by a supranuclear lesion. Other clinical and radiologic evedence indicated that there was a lesion in the rostral midbrain. A metastatic tumor, found in the right pretectum at autopsy, probably produced the ophthalmoplegia by interrupting axons destined for the superior rectus portion of the homolateral oculomotor nucleus and the interior oblique portion of the contralateral oculomotor nucleus.