1. Ocular tilt reaction due to a mesencephalic lesion in juvenile polyarteritis nodosa.
- Author
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Ragge NK, Harris CM, Dillon MJ, Chong WK, Elston J, and Taylor DS
- Subjects
- Aspirin therapeutic use, Brain Diseases diagnosis, Brain Diseases drug therapy, Child, Preschool, Cyclophosphamide therapeutic use, Diplopia drug therapy, Drug Therapy, Combination, Female, Head Movements, Humans, Kidney Diseases diagnostic imaging, Kidney Diseases drug therapy, Magnetic Resonance Imaging, Nystagmus, Pathologic drug therapy, Polyarteritis Nodosa drug therapy, Prednisolone therapeutic use, Radiography, Ranitidine therapeutic use, Saccades, Strabismus drug therapy, Tegmentum Mesencephali drug effects, Brain Diseases etiology, Diplopia etiology, Nystagmus, Pathologic etiology, Polyarteritis Nodosa complications, Strabismus etiology, Tegmentum Mesencephali pathology
- Abstract
Purpose: To describe a case of ocular tilt reaction caused by vasculitic lesions in the midbrain in a child with polyarteritis nodosa., Design: Observational case report., Methods: A 5-year-old girl with a chronic illness developed diplopia associated with a left head tilt, right hypertropia, torsional nystagmus, slowed vertical saccades and poor convergence. Fundoscopic examination demonstrated conjugate leftward torsion of the eyes consistent with a sustained ocular tilt reaction.Renal angiography confirmed polyarteritis nodosa and cerebral magnetic resonance imaging demonstrated mesencephalic pathology., Conclusions: Polyarteritis nodosa is a difficult condition to diagnose in a child and can cause brainstem lesions. This rare case of ocular tilt reaction of midbrain origin highlights that a sustained head tilt in a child can be due to brainstem pathology, rather than a fourth nerve palsy. more...
- Published
- 2003
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