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Convergence spasm due to aquaporin-positive neuromyelitis optica spectrum disorder.


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.

SUBMITTER: Ozcelik P 

PROVIDER: S-EPMC5721560 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Convergence spasm due to aquaporin-positive neuromyelitis optica spectrum disorder.

Özçelik Pınar P   Tanriverdizade Tural T   Men Süleyman S   Akdal Gülden G  

eNeurologicalSci 20170306


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 unreacti  ...[more]

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