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Published on: March 21, 2013
An unusual cause of head drops
Rakesh Kumar Jain1, Philip Anslow, Michael G Pike
1Department of Paediatric Neurology, Children's Hospital, Oxford, UK. drjainrakesh@yahoo.co.in
Summary
Congenital vertical ocular motor apraxia can signal underlying neurometabolic issues. A rare case highlights stroke in the vessel of Percheron as a potential cause in children.
Area of Science:
- Neurology
- Pediatrics
- Neuro-ophthalmology
Background:
- Vertical ocular motor apraxia (VOMA) necessitates evaluation for underlying neurometabolic disorders.
- Congenital VOMA is rare, with potential causes including perinatal stroke, hypoxia, or kernicterus.
Observation:
- A 5-year-old girl presented with congenital VOMA.
- Brain MRI revealed symmetrical high signal intensities in the inferomedial thalamic nuclei.
Findings:
- The observed MRI findings were localized to the territory of the vessel of Percheron, a rare variant of the posterior cerebral artery.
- This suggests a specific pattern of childhood stroke associated with congenital VOMA.
Implications:
- Recognizing stroke in the vessel of Percheron as a cause of congenital VOMA can prevent extensive and unnecessary investigations.
- Highlights the importance of neuroimaging in diagnosing rare pediatric neurological conditions.
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