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Journal of Child Neurology
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Article

Paroxysmal Tonic Upgaze Presenting as a Clinical Isolated Syndrome

Nesrin Senbil, MD*, Deniz Yilmaz, MD, Deniz Yüksel, MD, and Yavuz Gürer, MD

Department of Child Neurology, Dr Sami Ulus Children’s Hospital, Ankara, Turkey

* To whom correspondence should be addressed. E-mail: senbilon{at}yahoo.com.


  Abstract

We report a 3.5-year-old boy with sudden onset of episodic upward deviation of the eyes that led to diagnosis of paroxysmal tonic upgaze. Cranial magnetic resonance imaging showed right-hand side dominant bilateral hyperintense lesions in the mesencephalon and the thalamus on T2-weighted images. These lesions suggested a demyelinating pathology. Corticosteroid treatment was started. The episodes of upward eye deviation and the lesions on magnetic resonance imaging completely resolved after 3 days and 3 months, respectively. After 2 years of follow-up, he was symptom-free. Our patient with an isolated brain stem syndrome and no mental status changes was diagnosed as having a clinical isolated syndrome.

First published on January 23, 2009, doi:10.1177/0883073808327836

Journal of Child Neurology 2009;24:600.

A more recent version of this article appeared on May 1, 2009

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