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Purpose: To report our experience with a case of a very atypical clinical onset of multiple sclerosis in a young boy during a COVID-19 infection.
Case Report: A 16-year-old boy was referred to our ophthalmology clinic with a complete isolated bilateral horizontal gaze palsy. The condition had onset suddenly 2 weeks prior and he had no associated symptoms, as well as no significant medical history. His corrected visual acuity was 0.0 logMAR in both eyes. While hospitalized, he was found infected with COVID-19. Subsequent brain MRI showed multiple lesions typical of a yet undiagnosed MS, as well as an active pontine plaque which was highly probable the cause of the horizontal gaze palsy. High-dose steroid treatment was initiated 1 week later, after the patient exhibited negative COVID-19 test results.
Conclusion: Clinical manifestations of MS are rarely seen in male teenagers and only a few cases of isolated bilateral horizontal gaze palsy have been reported as the initial manifestation, but never during concomitant COVID-19 infection. We presume that the presence of COVID-19 may have been a neuroinflammatory trigger of underlying MS.
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http://dx.doi.org/10.1177/11206721221113910 | DOI Listing |
Cerebellum
September 2025
Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, MD, USA.
Spinocerebellar ataxia type 27B (SCA27B), caused by GAA repeat expansions in FGF14, is an increasingly recognized form of late-onset cerebellar ataxia. However, early diagnosis remains challenging due to mild or absent cerebellar motor signs and often normal brain magnetic resonance imaging (MRI). Oculovestibular abnormalities, although prevalent, are frequently overlooked and not captured by standard clinical scales such as the Scale for the Assessment and Rating of Ataxia (SARA).
View Article and Find Full Text PDFInvest Ophthalmol Vis Sci
September 2025
Department of Ophthalmology, University of California, Los Angeles, Los Angeles, California, United States.
Purpose: Simulations suggest that displacement of rectus extraocular muscle pulleys in superior oblique (SO) palsy accounts for incomitant strabismus patterns even without postulating SO contractile weakness. We asked how rectus extraocular muscle pulleys reorient during head tilt in SO palsy.
Methods: In 13 subjects with unilateral SO palsy, supine magnetic resonance imaging (MRI) in 2-mm-thick quasi-coronal planes in target-controlled central gaze was repeated in both lateral decubitus positions equivalent to 90° head tilts.
BMJ Case Rep
September 2025
Ophthalmology, Maulana Azad Medical College, New Delhi, India.
Insult to the midbrain vertical gaze pathways results in impaired downgaze, upgaze or both. Downgaze palsies are rarer and are often accompanied by horizontal gaze anomalies.
View Article and Find Full Text PDFAsian J Neurosurg
September 2025
Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
The thalamus, a gray matter structure, is a crucial relay for various afferent and efferent pathways in the brain. It receives its primary blood supply from the thalamoperforating and thalamogeniculate branches of the posterior cerebral arteries. Damage to the thalamus can lead to classical sensorimotor and amnestic syndromes, as well as neuro-ophthalmological manifestations, including vertical gaze palsy (VGP), pseudo-abducens palsy, skew deviation, cerebral ptosis, and Horner's syndrome.
View Article and Find Full Text PDFFront Aging Neurosci
August 2025
Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL, United States.
Introduction: Skilled bimanual coordination is an essential component of activities of daily living that relies on complex interactions between the limbs, yet how age-related changes impact asymmetries in visuomotor control during these tasks remains largely unknown. In the present study, we examined both motor performance and visual attention distribution in non-rhythmic continuous bimanual tasks and investigated the effect of aging.
Methods: Twelve right-handed young adults (YA) and twelve right-handed older adults (OA) performed a bimanual tracking task in which each hand controlled a cursor using a robotic device to track the upward movement of a horizontal target line simultaneously and independently.