TY - JOUR T1 - Bilateral paramedian pontine infarcts: a rare cause of bilateral horizontal gaze palsy JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2019-229503 VL - 12 IS - 10 SP - e229503 AU - Dmitriy Chernov AU - Maria Elizabeth Karavassilis AU - Farida Hassan AU - Mohit Bhandari Y1 - 2019/10/01 UR - http://casereports.bmj.com/content/12/10/e229503.abstract N2 - 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. ER -