Downgaze paresis following severe head trauma in a child.
A 4 1/2-year-old girl developed a downgaze paresis following severe head trauma. Magnetic resonance imaging showed evidence of peri-aqueductal lesions in the rostral midbrain in the region of the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF). Twenty five weeks following the injury, the downgaze paresis remained unchanged but she developed convergence retraction nystagmus on attempted upgaze. Repeat imaging did not show any change in the lesions in the rostral midbrain. This report provides further evidence for the riMLF in the control of downgaze, and a synkinesis is postulated for the development of the convergence retraction nystagmus.
Department of Ophthalmology, Royal Liverpool Children's NHS Trust, Royal Liverpool Children's Hospital, Alder Hey, UK.
S B
SB
Kaye
N
N
Wright
A
A
Ward
L
L
Abernethy
R
R
Appleton
A
A
Chandna
D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D005133:Eye Movements; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010291:Paresis / Q000209:etiology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed