Kuroki K, Taguchi H, Sumida M
Department of Neurosurgery, Hiroshima General Hospital, Japan.
No To Shinkei. 1998 Dec;50(12):1125-7.
A case with non-paralytic pontine exotropia due to brainstem infarction is reported. A 58-year-old male developed sudden onset diplopia. Ocular motor findings were as follows; in forward gaze, the left eye was in abduction position. Leftward gaze, the right eye did not adduct with left beating nystagmus of left eye. Rightward gaze, both eyes could make full excursion and upward, downward gaze were possible. These findings was noted at only acute phase, 7 days later NPPE was disappeared. MRI revealed spotty lesion in the paramedian portion of the mid pontine tegmentum. It is important to observe ocular movement at acute phase because NPPE is very important sign in diagnosis of brainstem disorders.