A case of double depressor palsy followed by pursuit deficit due to sequential infarction in bilateral thalamus and right medial superior temporal area.

Published on Dec 1, 2017in International Ophthalmology1.314
· DOI :10.1007/S10792-016-0407-0
Su Jin Kim3
Estimated H-index: 3
(Gyeongsang National University),
Myeong In Yeom3
Estimated H-index: 3
Seung Uk Lee6
Estimated H-index: 6
(Kosin University)
Background We present a unique case of a patient who suffered two rare events affecting the supranuclear control, first of the vertical and second of the horizontal eye movements. The first event involved bilateral thalamic infarcts that resulted in double depressor palsy. The second event occurred 1 year later and it involved supranuclear control of horizontal eye movements creating pursuit deficit.
📖 Papers frequently viewed together
3 Authors (和弘 長嶺, ..., 紘一 中尾)
6 Citations
#1Aziz Rassi NetoH-Index: 2
Last. Fernando Menezes BragaH-Index: 10
view all 3 authors...
Thirty fresh human brains were studied regarding to the anatomy of the posterior thalamoperforating arteries (PThPA): origin, number, diameter, traject, distance from the basilar artery bifurcation, type of distribution and correspondent area of vascularization. Most of the PThPAs originated proximally in the posterior cerebral artery (PCA), irrigating the cerebral, peduncles, mammilary bodies, ventral portion of midbrain and, through the posterior perforated substance, the medial portion of tha...
2 CitationsSource
PURPOSE: Pseudo-abducens palsy is a neurologic limitation in abduction with an intact abducens nerve. This rare condition can be observed when voluntary eye movements show impairment in lateral gaze, yet the vestibulo-ocular reflex (VOR) demonstrates full abduction. The intact VOR indicates the integrity of the infranuclear abducens nerve, thus suggesting that a pseudo-abducens palsy is likely caused by supranuclear pathology. CASE REPORT: A 63-year-old African American man presented with sudden...
2 CitationsSource
1 CitationsSource
#1Eva Guy Rodriguez (Lenox Hill Hospital)H-Index: 1
#2Jane A Lee (Lenox Hill Hospital)H-Index: 1
The Artery of Percheron is a rare vascular variant in which a single dominant thalamoperforating artery arises from one P1 segment and bifurcates to supply both paramedian thalami. Occlusion of this uncommon vessel results in a characteristic pattern of bilateral paramedian thalamic infarcts with or without mesencephalic infarctions. We report a case of a 31-year-old man with acute bilateral thalamic infarcts and a truncated Artery of Percheron demonstrated on magnetic resonance angiography (MRA...
27 CitationsSource
#1Yat-Fung Shea (HKU: University of Hong Kong)H-Index: 15
#2Oi Yee LinH-Index: 3
Last. James K H LukH-Index: 1
view all 4 authors...
8 Citations
#1Nicholas A. Lazzaro (UofU: University of Utah)H-Index: 1
#2B. Wright (UofU: University of Utah)H-Index: 1
Last. Anne G. Osborn (UofU: University of Utah)H-Index: 49
view all 9 authors...
BACKGROUND AND PURPOSE: Occlusion of the AOP results in a characteristic pattern of ischemia: bilateral paramedian thalamus with or without midbrain involvement. Although the classic imaging findings are often recognized, only a few small case series and isolated cases of AOP infarction have been reported. The purpose of this study was to characterize the complete imaging spectrum of AOP infarction on the basis of a large series of cases obtained from multiple institutions. MATERIALS AND METHODS...
255 CitationsSource
#1Sukh Que ParkH-Index: 11
#2Hack-Gun Bae (SCH: Soonchunhyang University)H-Index: 13
Last. Choi Sk (Soonchunhyang University Hospital)H-Index: 3
view all 6 authors...
Objective : The aim of this study was to investigate the morphological characteristics of the thalamoperforating arteries that arise from the P1 segment of the posterior cerebral artery. Methods : Thalamoperforating arteries located in the interpeduncular fossa were dissected in 26 formalin-fixed human cadaver brains. We investigated the origin site of thalamoperforating arteries from the P1 segment, number and diameter, and variations in their origin. Results : Thalamoperforating arteries arose...
12 CitationsSource
#1Suvankar Pal (Western General Hospital)H-Index: 23
#2E FergusonH-Index: 1
Last. R. Al-Shahi SalmanH-Index: 9
view all 4 authors...
A 45-year-old woman with Coffin–Lowry syndrome, but without risk factors for cerebrovascular disease, awoke with double vision and unsteadiness on her feet. Examination revealed a skew deviation of the eyes and diplopia on downgaze due to a “double depressor” palsy of the inferior rectus and superior oblique muscles. Her gait was unsteady with a tendency to veer left. Brain computed tomography (CT) and MRI confirmed bilateral paramedian thalamic infarcts (figs 1, 2). CT angiogram of the aortic a...
4 CitationsSource
#1Frank Thömke (University of Mainz)H-Index: 22
#2Hanns Christian Hopf (University of Mainz)H-Index: 29
Abstract Background The existence of a prenuclear abduction paresis is still debated. Methods In a retrospective design, we identified 22 patients with isolated unilateral (n = 20) or bilateral (n = 2) abduction paresis and electrophysiologic abnormalities indicating rostral pontine and/or mesencephalic lesions. Another 11 patients had unilateral abduction paresis with additional ocular motor abnormalities indicating midbrain dysfunction. Eight of these 11 patients also had electrophysiological ...
13 CitationsSource
#1Gerald Wiest (University of Vienna)H-Index: 15
#2Reinhold MallekH-Index: 1
Last. Christoph BaumgartnerH-Index: 58
view all 3 authors...
Article abstract The supranuclear pathways for vergence eye movements are poorly understood. The authors report a 57-year-old patient who presented with selective loss of vergence control and dissociation of light and near reaction. MRI showed a symmetric paramedian thalamic infarction without midbrain lesion. The findings suggest that this syndrome is due to an interruption of supranuclear fibers to midbrain vergence neurons.
15 CitationsSource
Cited By2
#1Tz-Shiang WeiH-Index: 1
#2Chun-Sheng HsuH-Index: 1
Last. Shin-Tsu ChangH-Index: 1
view all 4 authors...
Holmes' tremor is an uncommon neurologic disorder following brain insults, and its pathogenesis is undefined. The interruption of the dento-rubro-thalamic tract and secondary deterioration of the nigrostriatal pathway are both required to initiate Holmes' tremor. We used nuclear medicine imaging tools to analyze a patient with concurrent infarction in different zones of each side of the thalamus. Finding whether the paramedian nuclear groups of the thalamus were injured was a decisive element fo...
#1Ahry Lee (KU: Korea University)H-Index: 2
#2Hyun Im Moon (Bundang Jesaeng Hospital)H-Index: 6
Last. Sung-Bom Pyun (KU: Korea University)H-Index: 2
view all 4 authors...