Unilateral reverse ocular bobbing caused by tuberous sclerosis.
A female aged 12 months with developmental delay and left-sided reverse ocular bobbing (rapid deviation of the eye upward and a slow return to the horizontal position) was observed. At birth, an upper left gingival mass, pathologically diagnosed as a benign granular cell tumour, was removed. On computed tomography (CT), left middle cerebral pedincular and midpontine lesions were seen. Magnetic resonance imaging revealed additional white matter hamartomas, corticosubcortical tubers, and subependymal nodules. The patient was re-examined at 36 months. Her general developmental quotient was equivalent to 23 months of age. Third cranial nerve functions and auditory brainstem response were normal. Her abnormal eye movements were still present. Reverse bobbing is usually observed in patients who are unconscious and who have significant pontine pathology and disruption of the reticular formation. This case is the first tuberous sclerosis-related ocular bobbing case to our knowledge and is interesting as the causative lesion was relatively mild, and ocular horizontal movements were preserved.
Karakas
Hakki Muammer
HM
Department of Radiology, Turgut Ozal Medical Center, Inonu University Medical Faculty, Malatya, Turkey. hkarakas@inonu.edu.tr
Yakinci
Cengiz
C
Firat
Ahmet Kemal
AK
Kahraman
Bayram
B
D001933:Brain Stem / Q000473:pathology; D002531:Cerebellum / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D015835:Ocular Motility Disorders / Q000209:etiology* / Q000473:pathology; D014402:Tuberous Sclerosis / Q000150:complications* / Q000473:pathology