Bilateral, vertical supranuclear gaze palsy following unilateral midbrain infarct.
BMJ Case Rep
; 13(11)2020 Nov 04.
Article
in English
| MEDLINE | ID: covidwho-957913
ABSTRACT
A 60-year-old man recently admitted for bipedal oedema, endocarditis and a persistently positive COVID-19 swab with a history of anticoagulation on rivaroxaban for atrial fibrillation, transitional cell carcinoma, cerebral amyloid angiopathy, diabetes and hypertension presented with sudden onset diplopia and vertical gaze palsy. Vestibulo-ocular reflex was preserved. Simultaneously, he developed a scotoma and sudden visual loss, and was found to have a right branch retinal artery occlusion. MRI head demonstrated a unilateral midbrain infarct. This case demonstrates a rare unilateral cause of bilateral supranuclear palsy which spares the posterior commisure. The case also raises a question about the contribution of COVID-19 to the procoagulant status of the patient which already includes atrial fibrillation and endocarditis, and presents a complex treatment dilemma regarding anticoagulation.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Pyrazoles
/
Pyridones
/
Atrial Fibrillation
/
Retinal Artery Occlusion
/
Ophthalmoplegia
/
Aspirin
/
Blindness
/
Coronavirus Infections
/
Brain Stem Infarctions
Type of study:
Case report
/
Diagnostic study
/
Prognostic study
Topics:
Long Covid
Language:
English
Year:
2020
Document Type:
Article
Affiliation country:
Bcr-2020-238422
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