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Related Experiment Videos

The child with divergence paresis

B Schanzer1, M Bordaberry, A R Jeffery

  • 1John F. Kennedy Medical Center, Edison, New Jersey, USA.

Survey of Ophthalmology
|June 23, 1998
PubMed
Summary

Divergence paralysis, a rare condition causing inward eye turning, can be linked to serious neurological issues. This case highlights a large pontomedullary glioma as a cause in a teenage patient.

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Area of Science:

  • Ophthalmology
  • Neurology
  • Pediatric Neurology

Background:

  • Divergence paralysis is a rare clinical finding characterized by comitant esotropia (inward turning of the eyes) when viewing distant objects.
  • While often benign and self-resolving, it can be associated with significant underlying neurological conditions.

Observation:

  • A 14-year-old female presented with a chief complaint of diplopia (double vision).
  • Clinical examination confirmed the presence of divergence paralysis.

Findings:

  • Magnetic resonance imaging (MRI) revealed a large pontomedullary glioma.
  • This finding establishes a direct link between the patient's divergence paralysis and a significant brain tumor.

Implications:

  • This case underscores the importance of thorough neurological investigation in patients presenting with divergence paralysis, even in younger individuals.
  • It highlights pontomedullary gliomas as a potential, albeit rare, cause of this ophthalmological sign.
  • Early diagnosis and management of underlying causes like brain tumors are crucial for favorable outcomes.

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