title: [Spasm of the near reflex. Treatment with botulinum toxin].
abstract: METHODS
  A 38-year old female with diplopia and esotropia, with limitation of ocular abduction in both eyes, with full abduction after doll's head rotation also being observed. She was diagnosed with spasm of the near reflex. Treatment with injections of botulinum toxin in both medial rectus has temporally resolved the convergence spasm.
  
  
  CONCLUSIONS
  Near reflex spasm is characterized as miosis, pseudomyopia, and convergent strabismus that lead to diplopia, blurred vision, headache, and variable, progressive, and intermittent esotropia. As the spasm worsens there will be limited ocular versions and ductions simulating a sixth nerve palsy. Botulinum toxin may be effective in some cases.
authors.affiliation: Sección de Motilidad Ocular, Departamento de Oftalmología, Hospital Gregorio Marañon, Madrid, España. Electronic address: pilimerino@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Merino
authors.affiliation: Sección de Motilidad Ocular, Departamento de Oftalmología, Hospital Gregorio Marañon, Madrid, España.
authors.forename: P
authors.initials: P
authors.lastname: Rojas
authors.affiliation: Sección de Motilidad Ocular, Departamento de Oftalmología, Hospital Gregorio Marañon, Madrid, España.
authors.forename: P
authors.initials: P
authors.lastname: Gómez de Liaño
authors.affiliation: Sección de Motilidad Ocular, Departamento de Oftalmología, Hospital Gregorio Marañon, Madrid, España.
authors.forename: G
authors.initials: G
authors.lastname: Franco Iglesias
mesh_terms: D000328:Adult; D019274:Botulinum Toxins, Type A / Q000494:pharmacology / Q000627:therapeutic use*; D004172:Diplopia / Q000209:etiology; D004948:Esotropia / Q000209:etiology; D005260:Female; D005356:Fibromyalgia / Q000150:complications; D006801:Humans; D008575:Meniere Disease / Q000150:complications; D015877:Miosis / Q000209:etiology; D010276:Parasympatholytics / Q000627:therapeutic use*; D012021:Reflex, Abnormal / Q000187:drug effects*; D013035:Spasm / Q000188:drug therapy*
chemical_list: D010276:Parasympatholytics; D019274:Botulinum Toxins, Type A
keywords: Botulinum toxin; Esotropía variable e intermitente; Espasmo del reflejo de cerca; Intermittent and variable esotropia; Near reflex spasm; Paresia VI nervio; Sixth nerve palsy; Toxina botulínica