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


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.

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Correspondence to Alessandra Rufa.

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Rufa, A., Cerase, A., Annunziata, P. et al. Transient supranuclear paresis of the abduction in viral encephalitis of the brainstem. Neurol Sci 31, 653–655 (2010).

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