PT  - JOURNAL ARTICLE
AU  - Chernov, Dmitriy
AU  - Karavassilis, Maria Elizabeth
AU  - Hassan, Farida
AU  - Bhandari, Mohit
TI  - Bilateral paramedian pontine infarcts: a rare cause of bilateral horizontal gaze palsy
AID  - 10.1136/bcr-2019-229503
DP  - 2019 Oct 01
TA  - BMJ Case Reports
PG  - e229503
VI  - 12
IP  - 10
4099  - http://casereports.bmj.com/content/12/10/e229503.short
4100  - http://casereports.bmj.com/content/12/10/e229503.full
SO  - BMJ Case Reports2019 Oct 01; 12
AB  - A 73-year-old man presented to accident and emergency with headache and diplopia. Examination of the eye movements revealed a bilateral complete horizontal gaze palsy. On admission, a CT scan of the brain was performed, which was unremarkable. An MRI of the brain was then performed, which confirmed tiny acute infarcts involving the pons and the right cerebellum. This man was promptly treated with aspirin 300 mg one time per day, as per the stroke pathway. Further diagnostic workup later revealed atrial flutter. This man was therefore commenced on apixaban. The differential diagnoses for bilateral gaze palsy include the following: multiple sclerosis, infarction, haemorrhage and space occupying lesion. Bilateral gaze palsy is often associated with other neurological symptoms.