Bilateral vertical gaze palsy due to midbrain infarct associated with iron deficiency anemia in a young boy.

GMS ophthalmology cases Pub Date : 2020-06-29 eCollection Date: 2020-01-01 DOI:10.3205/oc000155
Virna M Shah, Ratnesh Ranjan, Mrunmayi Jeste, Peter MacIntosh, Duraiswamy Ashwath
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Abstract

An 8-year-old boy presented with complaints of sudden-onset binocular vertical diplopia of one day duration. Ophthalmic examination showed restricted up- and downgaze movement with rotatory nystagmus. Systemic investigations revealed iron-deficiency anemia and localized acute infarct in the left paramedian rostral and dorsal part of the upper midbrain at the level of the red nucleus on magnetic resonance imaging. The patient was started on oral iron supplement, which resulted in symptomatic as well as clinical improvement after 2 weeks.

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少男中脑梗死合并缺铁性贫血导致双侧垂直凝视性麻痹。
一个8岁的男孩提出抱怨突然发作的双眼垂直复视持续一天。眼科检查显示上下视线运动受限并伴有旋转性眼球震颤。全身检查显示,在磁共振成像的红核水平上,中脑上部左副正中吻侧和背侧出现缺铁性贫血和局部急性梗死。患者开始口服补铁,2周后症状及临床均有改善。
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