Paroxysmal tonic upgaze presenting as a clinical isolated syndrome.
We report a 3.5-year-old boy with sudden onset of episodic upward deviation of the eyes that led to diagnosis of paroxysmal tonic upgaze. Cranial magnetic resonance imaging showed right-hand side dominant bilateral hyperintense lesions in the mesencephalon and the thalamus on T2-weighted images. These lesions suggested a demyelinating pathology. Corticosteroid treatment was started. The episodes of upward eye deviation and the lesions on magnetic resonance imaging completely resolved after 3 days and 3 months, respectively. After 2 years of follow-up, he was symptom-free. Our patient with an isolated brain stem syndrome and no mental status changes was diagnosed as having a clinical isolated syndrome.
Senbil
Nesrin
N
Department of Child Neurology, Dr Sami Ulus Children's Hospital, Ankara Turkey. senbilon@yahoo.com
Yilmaz
Deniz
D
Yüksel
Deniz
D
Gürer
Yavuz
Y
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000473:pathology*; D015835:Ocular Motility Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D013577:Syndrome; D013788:Thalamus / Q000473:pathology*
D000305:Adrenal Cortex Hormones