Episode 263: Neurology VMR – Diplopia
The Clinical Problem Solvers
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How Do the Nuclei on the Left and Right Talk to Each Other?
So we'll focus on horizontal gaze. That's the easier one to understand if the patient happens to have verticaled aplopia. It's more complicated to understand. To move in horizontal gaze, we need lateral rectus on one side and medial rectus on the other side coordinated. And then we need to move our left and right eye together. So how do those nuclei on the left and on the right talk to each other? For example, for horizontal gaze, if I want to look left, I need my left lateral rectus by six, I write medial rectus by three. If you have binocular deplopia, it has to be one of those structures involved for
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