RT Journal Article
SR Electronic
T1 Bilateral paramedian pontine infarcts: a rare cause of bilateral horizontal gaze palsy
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e229503
DO 10.1136/bcr-2019-229503
VO 12
IS 10
A1 Dmitriy Chernov
A1 Maria Elizabeth Karavassilis
A1 Farida Hassan
A1 Mohit Bhandari
YR 2019
UL http://casereports.bmj.com/content/12/10/e229503.abstract
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.