title: [Successful steroid pulse therapy for acute unilateral oculomotor nerve palsy associated with norovirus infection].
abstract: We report a 4-year-old boy who developed acute unilateral oculomotor nerve palsy following Norovirus infection. He visited our hospital because of diplopia three weeks after Norovirus gastroenteritis. Physical examination showed only the left oculomotor nerve palsy. Enhanced MRI of the brain and cerebrospinal fluid examination revealed no abnormality. Anti GQlb antibody was negative. Because blepharoptosis and ophthalmoplegia progressed rapidly, we performed three courses of steroid pulse therapy (methylpredonisolone 30 mg/kg x 3 day/course) combined with vitamin B6. Autonomic dysfunction (isocorea, light reflex) began to improve in several days and subsequently extraocular movements (blepharoptosis, infraduction supraduction, adducent in order) resolved completely in one month. Idiopathic oculomotor paralysis is usually believed to be selflimited, but steroid pulse therapy should to be considered in cases ocular paralysis is so severe or progressive that immune-mediated mechanism was presumed.
authors.affiliation: Division of Pediatric Neurology, Osaka City General Hospital, Osaka. gpkichiro@kcd.biglobe.ne.jp
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kuki
authors.forename: Hisashi
authors.initials: H
authors.lastname: Kawawaki
authors.forename: Shin
authors.initials: S
authors.lastname: Okazaki
authors.forename: Hiroko
authors.initials: H
authors.lastname: Ikeda
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Tomiwa
mesh_terms: D017250:Caliciviridae Infections / Q000150:complications*; D002675:Child, Preschool; D005759:Gastroenteritis / Q000150:complications*; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D029322:Norovirus; D015840:Oculomotor Nerve Diseases / Q000188:drug therapy*; D020551:Pulse Therapy, Drug
chemical_list: D008775:Methylprednisolone