We describe a rare case in which both wall-eyed bilateral internuclear 
ophthalmoplegia syndrome and vertical one-and-a-half syndrome were observed in a 
68-year-old man with acute ischemic stroke. Concurrent horizontal and vertical 
gaze palsies are rare because the corresponding gaze centers are anatomically 
separated. The complicated gaze palsies observed in this patient might have 
resulted from long, vertical lesions affecting oculomotor pathways for both 
sides of the brain stem.