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The medial longitudinal fasciculus (MLF) is a prominent bundle of nerve fibres which pass within the ventral/anterior portion of periaqueductal gray of the mesencephalon (midbrain). It contains the interstitial nucleus of Cajal, responsible for oculomotor control, head posture, and vertical eye movement.
The MLF interconnects interneurons of each abducens nucleus with motor neurons of the contralateral oculomotor nucleus; thus, the MLF mediates coordination of horizontal (side to side) eye movements, ensuring the two eyes move in unison (thus also enabling saccadic eye movements). The MLF also contains fibers projecting from the vestibular nuclei to the oculomotor and trochlear nuclei as well as the interstitial nucleus of Cajal; these connections ensure that eye movements are coordinated with head movements (as sensed by the vestibular system).
Descending fibers arise from the superior colliculus in the rostral midbrain (for visual reflexes), the accessory oculomotor nuclei in the rostral midbrain for visual tracking, and the pontine reticular formation, which facilitates extensor muscle tone. Ascending tracts arise from the vestibular nucleus and terminate in the oculomotor nucleus (of the oculomotor nerve, CN III), the trochlear nucleus (of the trochlear nerve, CN IV), and the abducens nucleus (of the abducens nerve, CN VI).
Structure
It contains the interstitial nucleus of Cajal,
Perihypoglossal nuclei
The three perihypoglossal nuclei project efferents to the three cranial nerve nuclei controlling extrinsic eye muscles through the MLF.
Medial vestibulospinal tract
The vestibulocerebellum receives vestibulocerebellar fibers from the vestibular nuclei, then projects back to the vestibular nuclei to influence medial vestibulospinal tract (MVST). The MVST then projects bilaterally to cervical and upper thoracic levels of the spinal cord to control head/neck movements in order to coordinate head-eye movements. In the cervical spinal cord, it descends as a component of the descending MLF. This is usually associated with involuntary jerky eye movements (nystagmus) of the abducting eye, a syndrome called internuclear ophthalmoplegia. This presents as nystagmus and diplopia. This was followed by Theodor Meynert in 1872 calling it posterior.