The purpose of this article is to highlight an uncommon combination of supranuclear downward gaze paralysis with bilateral eyelid ptosis in a 53-years-old man with a radiation induced midbrain tumor and to discuss the aspects regarding the centers and pathways that mediate supranuclear vertical gaze movements.
midbrain; rostral intersticial medial longitudinal fasciculus nucleus; downgaze paralysis; eyelid ptosis; tumor