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A patient presented with bilateral upward gaze palsy and right-sided ophthalmoplegia as prominent signs of a midbrain infarction. The lesion involved the third nerve nuclear complex and intramedullary nerve root of the right side. It extended to the hypothalamus, but was exclusively right-sided. This midbrain lesion may have been responsible for the left-sided superior rectus palsy, since this finding is consistent with current models of organization in primates, indicating that the superior rectus muscle is innervated by the contralateral oculomotor nucleus.
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Kobayashi et al. (1986) studied this question.
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