Paroxysmal tonic upgaze presenting as a clinical isolated syndrome

We report a 3.5-year-old boy with sudden onset of episodic upward deviation of the eyes that led to diagnosis of paroxysmal tonic upgaze. Cranial magnetic resonance imaging showed right-hand side dominant bilateral hyperintense lesions in the mesencephalon and the thalamus on T2-weighted images. The...

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Bibliographic Details
Published inJournal of child neurology Vol. 24; no. 5; p. 600
Main Authors Senbil, Nesrin, Yilmaz, Deniz, Yüksel, Deniz, Gürer, Yavuz
Format Journal Article
LanguageEnglish
Published United States 01.05.2009
Subjects
Adrenal Cortex Hormones - therapeutic use
Child, Preschool
Diagnosis, Differential
Follow-Up Studies
Functional Laterality
Humans
Magnetic Resonance Imaging
Male
Mesencephalon - pathology
Ocular Motility Disorders - diagnosis
Ocular Motility Disorders - drug therapy
Ocular Motility Disorders - pathology
Syndrome
Thalamus - pathology
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Summary:We report a 3.5-year-old boy with sudden onset of episodic upward deviation of the eyes that led to diagnosis of paroxysmal tonic upgaze. Cranial magnetic resonance imaging showed right-hand side dominant bilateral hyperintense lesions in the mesencephalon and the thalamus on T2-weighted images. These lesions suggested a demyelinating pathology. Corticosteroid treatment was started. The episodes of upward eye deviation and the lesions on magnetic resonance imaging completely resolved after 3 days and 3 months, respectively. After 2 years of follow-up, he was symptom-free. Our patient with an isolated brain stem syndrome and no mental status changes was diagnosed as having a clinical isolated syndrome.
ISSN:1708-8283
DOI:10.1177/0883073808327836