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Neurological Sciences

, Volume 31, Issue 5, pp 653–655 | Cite as

Transient supranuclear paresis of the abduction in viral encephalitis of the brainstem

  • Alessandra Rufa
  • Alfonso Cerase
  • Pasquale Annunziata
  • Lorenzo De Santi
  • Rosaria Buccoliero
  • Lucia Monti
  • Antonio Federico
Case Report

Abstract

The supranuclear paresis of the abducens system, also known as posterior internuclear ophthalmoplegia of abduction, is a very rare disorder clinically characterized by unilateral or bilateral abduction paresis sometimes associated with nystagmus of the contralateral adducting eye, slowing of abduction saccades, and intact horizontal vestibulo-ocular reflex. Here, we report a 35-year-old woman who presented transient left side abduction deficit in conjunction, as the only symptom of self-limited viral encephalitis of the brainstem. Brain MRI including DWI and ADC maps showed an area of abnormal signal intensity in the mid-right ponto-mesencephalic junction. PCR analysis of cerebrospinal fluid showed an enterovirus infection. Spontaneous clinical recovery rapidly occurred 2 days after onset. The brainstem lesion was undetectable at 5-week brain MRI follow-up.

Keywords

Supranuclear abduction palsy Ponto-mesencephalic junction Encephalitis Benign MRI-DW Enterovirus 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Alessandra Rufa
    • 1
  • Alfonso Cerase
    • 2
  • Pasquale Annunziata
    • 1
  • Lorenzo De Santi
    • 1
  • Rosaria Buccoliero
    • 1
  • Lucia Monti
    • 2
  • Antonio Federico
    • 1
  1. 1.Dipartimento di Scienze Neurologiche e del ComportamentoUniversità di SienaSienaItaly
  2. 2.UOC di Neuroradiologia Diagnostica e TerapeuticaAzienda Ospedaliera Universitaria Senese, Policlinico “Santa Maria alle Scotte”SienaItaly

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