Acquired esotropia as initial manifestation of Arnold-Chiari malformation.
A 13-year-old patient originally presented with a divergence palsy and gaze-evoked nystagmus. Over a short period of time, the esotropia became increasingly comitant and was successfully treated with strabismus surgery. Three years later, she developed downbeat nystagmus. An Arnold-Chiari Malformation could only be demonstrated using nuclear magnetic resonance imaging (MRI). Subsequent neurosurgical decompression resulted in resolution of the downbeat nystagmus with maintenance of single binocularity.
D000293:Adolescent; D001139:Arnold-Chiari Malformation / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D004948:Esotropia / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D009759:Nystagmus, Pathologic / Q000209:etiology; D009760:Nystagmus, Physiologic; D013285:Strabismus / Q000175:diagnosis*