A Case of Acquired Ocular Motor Apraxia Accompanied with Esotropia due to Multiple Brain Infarcts

PURPOSE: We present a case of acquired ocular motor apraxia accompanied with esotropia due to multiple brain infarcts. CASE SUMMARY: A 59-year-old male was referred for diplopia that started 9 years before presentation and continued after multiple brain infracts including right cerebellum, right occipital lobe, medulla oblongata and inferior pons. At initial examination, his best corrected visual acuity was 20/22 in the right eye and 20/25 in the left eye and he had 12 prism diopter (PD) esotropia at distance and near in primary gaze with correction. His duction and version were normal; however, his horizontal saccade was notably decreased. Two years and 8 months after presentation, the patient had 15 PD esotropia at distance and near with correction. His duction and version were normal and vertical saccadic eye movements were observed. However, horizontal saccade disappeared. The patient also exhibited a distinguishing head thrust following the order for saccadic eye movement. He was diagnosed with an acquired ocular motor apraxia accompanied with esotropia. During the follow-up period the patient underwent bilateral recession of the medial rectus. The usual diplopia and his horizontal esodeviation improved to 3 PD of esotropia at distance. CONCLUSIONS: Multiple brain infarcts can result in an acquired ocular motor apraxia accompanied with esotropia. Varying types of ocular motor disorders should be considered in patients with a previous medical history of brain infarct.

Unilateral congenital ocular motor apraxia: a case report

Congenital ocular motor apraxia (COA), first described by Cogan in 1953, is a rare disorder which shows characteristic defects of the horizontal voluntary saccades, and compensatory head thrust. Until now, most cases have showed a presumably congenital origin, bilaterality, and a tendency to various stages of recovery with aging. But the cause and mechanism of COA are not completely known. Occasionally, it combines with other neurologic abnormalities and metabolic diseases such as Gaucher's disease exhibit similar clinical characteristics to COA. We recently experienced a case of a 3-year-old girl who showed the clinical features of unilateral congenital ocular motor apraxia.

Congenital Ocular Motor Apraxia

Congenital ocular motor apraxia (COA), first described by Cogan in 1953, is a rare disorder which shows characteristic defect of horizontal voluntary saccades and head thrust. Until now, most cases have showed presumably congenital in origin, bilaterality, and tendency of various recovery with aging. But the causes and mechanisms of COA are not known. Occasionally, it combines with other neurologic abnormalities and the metabolic diseases such as Gaucher's disease which exhibits similar clinical characteristics of COA. We recently experienced a 3 years old girl who showed clinical features of unilateral congenital ocular motor apraxia.

Congenital Ocular Motor Apraxia

Congenital ocular motor apraxia (COA), first described by Cogan in 1953, is a rare disorder which shows characteristic defect of horizontal voluntary saccades and head thrust. Until now, most cases have showed presumably congenital in origin, bilaterality, and tendency of various recovery with aging. But the causes and mechanisms of COA are not known. Occasionally, it combines with other neurologic abnormalities and the metabolic diseases such as Gaucher's disease which exhibits similar clinical characteristics of COA. We recently experienced a 3 years old girl who showed clinical features of unilateral congenital ocular motor apraxia.