title: Mesencephalic clefts with associated eye movement disorders.
abstract: OBJECTIVE
  To describe two patients with mesencephalic midline clefts and associated eye movement disorders.
  
  
  METHODS
  Case reports.
  
  
  RESULTS
  The first patient developed bilateral internuclear ophthalmoplegia with exotropia, reduced convergence, right ptosis, right fourth-nerve palsy, and right elevator palsy several years after meningitis with hydrocephalus. The second patient had bilateral internuclear ophthalmoplegia with exotropia, reduced convergence, bilateral ptosis, limited upward gaze, and right hypertropia since childhood. In both patients, magnetic resonance imaging showed a midline cleft extending from the cerebral aqueduct into the midbrain.
  
  
  CONCLUSIONS
  It is likely that the clefts affected the oculomotor nuclei and medial longitudinal fasciculi, accounting for the eye movement disorders.
authors.affiliation: Neuro-ophthalmology Service, Harvard Medical School, Brigham and Women's Hospital, Boston, Mass, USA.
authors.forename: W D
authors.initials: WD
authors.lastname: Lagreze
authors.forename: J E
authors.initials: JE
authors.lastname: Warner
authors.forename: A A
authors.initials: AA
authors.lastname: Zamani
authors.forename: G K
authors.initials: GK
authors.lastname: Gouras
authors.forename: I J
authors.initials: IJ
authors.lastname: Koralnik
authors.forename: D C
authors.initials: DC
authors.lastname: Bienfang
mesh_terms: D000328:Adult; D001763:Blepharoptosis / Q000209:etiology; D001927:Brain Diseases / Q000150:complications* / Q000175:diagnosis; D003290:Convergence, Ocular; D005099:Exotropia / Q000209:etiology; D005133:Eye Movements; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000473:pathology*; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000209:etiology*; D009886:Ophthalmoplegia / Q000209:etiology