Özçelik P, Tanriverdizade T, Men S, Akdal G. Convergence spasm due to aquaporin-positive neuromyelitis optica spectrum disorder.
eNeurologicalSci 2017;
7:7-8. [PMID:
29260017 PMCID:
PMC5721560 DOI:
10.1016/j.ensci.2017.03.001]
[Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 03/01/2017] [Indexed: 11/19/2022] Open
Abstract
A female 27 presented with nausea and diplopia for 1 week. On examination she had normal vertical gaze but would develop convergence with miosis whenever she made horizontal saccades. Pupils were 6 mm and unreactive to light. MRI showed extensive hyperintensity in the dorsal midbrain and thalamus. Spinal MRI and CSF were both normal. Serum aquaporin-4-antibody was positive. She was treated with steroids and plasmapheresis and after 3 months convergence spasm resolved but pupils remained unreactive. Neuromyelitis optica often presents with brainstem signs, rarely a dorsal midbrain syndrome. Convergence spasm is occasionally of organic neurologic origin.
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