title: Transient supranuclear paresis of the abduction in viral encephalitis of the brainstem.
abstract: The supranuclear paresis of the abducens system, also known as posterior internuclear ophthalmoplegia of abduction, is a very rare disorder clinically characterized by unilateral or bilateral abduction paresis sometimes associated with nystagmus of the contralateral adducting eye, slowing of abduction saccades, and intact horizontal vestibulo-ocular reflex. Here, we report a 35-year-old woman who presented transient left side abduction deficit in conjunction, as the only symptom of self-limited viral encephalitis of the brainstem. Brain MRI including DWI and ADC maps showed an area of abnormal signal intensity in the mid-right ponto-mesencephalic junction. PCR analysis of cerebrospinal fluid showed an enterovirus infection. Spontaneous clinical recovery rapidly occurred 2 days after onset. The brainstem lesion was undetectable at 5-week brain MRI follow-up.
authors.affiliation: Dipartimento di Scienze Neurologiche e del Comportamento, Università di Siena, Viale Bracci 2, 53100, Siena, Italy. rufa@unisi.it
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rufa
authors.forename: Alfonso
authors.initials: A
authors.lastname: Cerase
authors.forename: Pasquale
authors.initials: P
authors.lastname: Annunziata
authors.forename: Lorenzo
authors.initials: L
authors.lastname: De Santi
authors.forename: Rosaria
authors.initials: R
authors.lastname: Buccoliero
authors.forename: Lucia
authors.initials: L
authors.lastname: Monti
authors.forename: Antonio
authors.initials: A
authors.lastname: Federico
mesh_terms: D000328:Adult; D001933:Brain Stem / Q000473:pathology / Q000821:virology*; D018792:Encephalitis, Viral / Q000150:complications* / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D013494:Supranuclear Palsy, Progressive / Q000209:etiology*