Temporary Divergence Paralysis in Viral Meningitis

A 43-year-old woman who reported diplopia and headache was found to have comitant esotropia at distance fixation and normal alignment at reading distance (divergence paralysis). Eye movement, including abduction, was normal as was the rest of the neurologic examination. Brain MRI was normal. Lumbar...

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Bibliographic Details
Published in:	Journal of neuro-ophthalmology Vol. 28; no. 2; pp. 111 - 113
Main Authors:	Bakker, Stef L. M, Gan, Ivan M
Format:	Journal Article
Language:	English
Published:	United States Lippincott Williams & Wilkins, Inc 01-06-2008
Subjects:	Adult Brain Stem - physiopathology Brain Stem - virology Cerebrospinal Fluid - virology Diplopia - physiopathology Diplopia - virology Encephalitis, Viral - complications Esotropia - physiopathology Esotropia - virology Eyeglasses Female Humans Magnetic Resonance Imaging Meningitis, Viral - complications Neural Pathways - physiopathology Neural Pathways - virology Ocular Motility Disorders - physiopathology Ocular Motility Disorders - virology Recovery of Function - physiology
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Summary:	A 43-year-old woman who reported diplopia and headache was found to have comitant esotropia at distance fixation and normal alignment at reading distance (divergence paralysis). Eye movement, including abduction, was normal as was the rest of the neurologic examination. Brain MRI was normal. Lumbar puncture showed an elevated opening pressure and a cerebrospinal fluid formula consistent with viral meningitis. The patient was treated with intravenous fluids and analgesics and with a temporary prism to alleviate diplopia. Within 3 weeks, she had fully recovered. This is the first report of divergence palsy in viral meningitis.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Case Study-2 ObjectType-Feature-4 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1070-8022 1536-5166
DOI:	10.1097/WNO.0b013e3181782561