Transient supranuclear paresis of the abduction in viral encephalitis of the brainstem |
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Authors: | Alessandra Rufa Alfonso Cerase Pasquale Annunziata Lorenzo De Santi Rosaria Buccoliero Lucia Monti Antonio Federico |
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Affiliation: | 1. Dipartimento di Scienze Neurologiche e del Comportamento, Università di Siena, Viale Bracci 2, 53100, Siena, Italy 2. UOC di Neuroradiologia Diagnostica e Terapeutica, Azienda Ospedaliera Universitaria Senese, Policlinico “Santa Maria alle Scotte”, Siena, Italy
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Abstract: | The supranuclear paresis of the abducens system, also known as posterior internuclear ophthalmoplegia of abduction, is a very rare disorder clinically characterized by unilateral or bilateral abduction paresis sometimes associated with nystagmus of the contralateral adducting eye, slowing of abduction saccades, and intact horizontal vestibulo-ocular reflex. Here, we report a 35-year-old woman who presented transient left side abduction deficit in conjunction, as the only symptom of self-limited viral encephalitis of the brainstem. Brain MRI including DWI and ADC maps showed an area of abnormal signal intensity in the mid-right ponto-mesencephalic junction. PCR analysis of cerebrospinal fluid showed an enterovirus infection. Spontaneous clinical recovery rapidly occurred 2 days after onset. The brainstem lesion was undetectable at 5-week brain MRI follow-up. |
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