Synergistic convergence and split pons in horizontal gaze palsy and progressive scoliosis in two sisters - PubMed (original) (raw)

Case Reports

Synergistic convergence and split pons in horizontal gaze palsy and progressive scoliosis in two sisters

Nitin R Jain et al. Indian J Ophthalmol. 2011 Mar-Apr.

Abstract

Synergistic convergence is an ocular motor anomaly where on attempted abduction or on attempted horizontal gaze, both the eyes converge. It has been related to peripheral causes such as congenital fibrosis of extraocular muscles (CFEOM), congenital cranial dysinnervation syndrome, ocular misinnervation or rarely central causes like horizontal gaze palsy with progressive scoliosis, brain stem dysplasia. We hereby report the occurrence of synergistic convergence in two sisters. Both of them also had kyphoscoliosis. Magnetic resonance imaging (MRI) brain and spine in both the patients showed signs of brain stem dysplasia (split pons sign) differing in degree (younger sister had more marked changes).

PubMed Disclaimer

Figures

Figure 1a

Figure 1a

Clinical picture of case 1 showing nine gazes

Figure 1b

Figure 1b

MRI brain of case 1, T2 axial, arrow denotes pontine cleft (split pons sign) (c) MRI spine of case 1, T2 coronal

Figure 1c

Figure 1c

MRI spine of case 1, T2 coronal

Figure 2a

Figure 2a

Clinical picture of case 2 showing nine gazes

Figure 2b

Figure 2b

MRI brain of case 2, T2 axial, arrow denotes pontine cleft

Figure 2c

Figure 2c

MRI spine of case 2, T2 coronal

Comment in

Similar articles

Cited by

References

    1. Kim JH, Hwang JM. Adduction on attempted abduction: The opposite of synergistic divergence. Arch Ophthalmol. 2006;124:918–20. - PubMed
    1. Pieh C, Berlis A, Lagrèze WA. Synergistic convergence in congenital extraocular muscle misinnervation. Arch Ophthalmol. 2008;126:574–6. - PubMed
    1. Khan AO, Oystreck DT, Al-Tassan N, Al-Sharif L, Bosley TM. Bilateral synergistic convergence associated with homozygous ROBO3 mutation (p.Pro771Leu) Ophthalmology. 2008;115:2262–5. - PubMed
    1. Serbaneasu I, Engle EC. Albert and Jakobiec’s Principles and Practice of Ophthalmology. 3rd ed. Philadelphia, PA: Elsevier Inc; 2008. Genetics of strabismus; pp. 4315–24.
    1. Rossi A, Catala M, Biancheri R, Di Comite R, Tortori-Donati P. MR imaging of brain-stem hypoplasia in horizontal gaze palsy with progressive scoliosis. Am J Neuroradiol. 2004;25:1046–8. - PMC - PubMed

Publication types

MeSH terms

LinkOut - more resources