Congenital ocular motor apraxia: sporadic and familial. Support for natural resolution

Four patients aged between 9 months and 17 years were detected to have congenital ocular motor apraxia (COMA) over a 10-month period. Three of them were siblings. All exhibited the classical signs of a horizontal saccadic palsy. However, the signs were less pronounced with increasing age of the patient. This supports the observations of other authors who have noted an age-related resolution. There was no evidence of other motor developmental delay in any of the patients and computed tomography revealed no abnormalities. Both these findings are in contradistinction to prior reports of central nervous system abnormalities and motor and speech difficulties in COMA. The family of three appears to be the largest sibling cluster reported so far.