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(Posterior parietal lesions reduce pursuit movements but do not cause a gaze palsy) With bilateral frontal lesions, the patient may be unable to turn his eyes voluntarily in any direction but retains xation and following movements, probably because pursuit movements are initiated in the parieto-occipital cortex Occasionally, a deep cerebral lesion, particularly a thalamic hemorrhage extending into the midbrain, will cause the eyes to deviate conjugately to the side opposite the lesion ( wrong-way gaze); the basis for this anamolous phenomenon is not established, but interference with descending oculomotor tracts in the midbrain has been postulated by Tijssen It should be emphasized that cerebral gaze paralysis is not attended by strabismus or diplopia, ie, the eyes move conjuugately The usual causes are vascular occlusion with infarction, hemorrhage, and abscess or tumor of the frontal lobe.

Brainstem Origin With regard to conjugate and horizontal gaze palsy, a unilateral lesion in the rostral midbrain tegmentum, by interrupting the cerebral pathways for horizontal conjugate gaze.

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print out range Use this parameter when you need to print out a range of pages. Use the constant print all document to print all pages, print current page to print the page the selection is on, print from to to print a simple range of pages by page numbers or section numbers, print range of pages to print a complex range of pages (for example, pages 1, 4, 9 16, 20), or print selection to print the current selection. page from Use this parameter to set the starting page when you use print out range print from to. page to Use this parameter to specify the ending page when you use print out range print from to. print copies Use this parameter to specify the number of copies when you need more than one for example, print copies 5 to print five copies. print out page type Use this parameter when you need to print out only odd pages (print odd pages only) or only even pages (print even pages only). You can also use print out page type print all pages to print all pages, but there s not much point, because Word does this anyway unless you tell it not to. For example, the following statement prints the selection in the active document:

Anatomic Considerations The fth nerve (Fig 47-1) is a mixed sensory and motor nerve It conducts sensory impulses from the greater part of the face and head; from the mucous membranes of the nose, mouth, and paranasal sinuses; and from the cornea and conjunctiva It also innervates the dura of the anterior and middle cranial fossae The cell bodies of the sensory part of the nerve lie in the gasserian, or semilunar, ganglion This, the largest sensory ganglion in humans, lies in the medial part of the middle cranial fossa at the base of the cranium The central axons of the ganglion cells form the sensory root These bers, on entering the mid pons, divide into short ascending and long descending branches The former are concerned mainly with tactile and light pressure sense and synapse with second-order neurons in the principal sensory nucleus.

Proprioceptive afferents from facial muscles and the masseter terminate in the mesencephalic nucleus The bers that mediate pain and temperature sensation do not end in these nuclei but form the unique anatomy of the long descending branches of the spinal trigeminal tract The latter pathway, which contains both facilitatory and inhibitory bers, together with its nucleus, extends from the junction of the pons and medulla to the uppermost segments (C2 or C3) of the spinal cord (as evidenced by the relief of facial pain after medullary trigeminal tractotomy) The spinal nucleus is a continuation of the spinal tract of Lissauer and substantia gelatinosa; the main sensory nucleus is a continuation of the nucleus of the medial lemniscus From all parts of the principal trigeminal sensory and spinal nuclei, second-order bers cross to the opposite side and ascend to the thalamus.

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