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).
Figures
Figure 1a
Clinical picture of case 1 showing nine gazes
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
MRI spine of case 1, T2 coronal
Figure 2a
Clinical picture of case 2 showing nine gazes
Figure 2b
MRI brain of case 2, T2 axial, arrow denotes pontine cleft
Figure 2c
MRI spine of case 2, T2 coronal
Comment in
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