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Abstract:
A 77-year-old man with autopsy-proven bilateral cerebral infarction had a periodic alternating conjugate horizontal ocular deviation for 2 days, which ceased shortly before death. There have been four previously reported patients with this disorder. The phenomenon suggests acute bilateral cerebral disease with a relatively intact brainstem.
Insights
Periodic alternating gaze deviation, a rare sign of severe brain damage, was observed in a patient with bilateral cerebral infarction. This finding indicates widespread cerebral disease affecting eye movement control.
Area of Science:
- Neurology
- Neuroscience
- Ophthalmology
Background:
- Periodic alternating gaze deviation is a rare neurological sign.
- It is typically associated with brainstem or cerebellar lesions.
Observation:
- A 77-year-old male patient presented with periodic alternating conjugate horizontal ocular deviation.
- This symptom persisted for 2 days before resolving shortly before death.
- Autopsy confirmed bilateral cerebral infarction.
Findings:
- The patient's ocular deviation suggests acute bilateral cerebral disease.
- The phenomenon points to a relatively intact brainstem despite extensive cerebral damage.
- This case adds to the four previously reported instances of this specific sign.
Implications:
- Periodic alternating gaze deviation can indicate severe, widespread cerebral pathology.
- This sign may help differentiate between cerebral and brainstem lesions in acute neurological events.
- Further research is needed to understand the precise mechanisms linking cerebral infarction to this ocular motor abnormality.