Dr.ANNU JOON, J17428
Skew deviations can simulate cyclovertical muscle palsies and create diagnostic dilemmas, internuclear ophthalmoplegias (INOs)often accompany skew deviations and congeal the presentations. We present 3 novel cases. Case 1 was a 18 year old girl with operated posterior fossa astrocytoma, she had features of bilateral 6th, 4th nerve palsies, V pattern and a left OTR with conjugate torsion. Her OTR resolved in 6 months but she had to undergo surgery for B/l SOP. Case 2 was a 4 year old boy who presented with bilateral INO due to multiple sclerosis, MRI brain showed subtle concordant demyelinating lesions that were overlooked and diagnosis of organophoshate poisoning returned. An elderly hypertensive had a stroke but his horizontal and torsional diplopia due to bilateral asymmetrical INO was not addressed. Correction of XT with due regard to torsional symptoms was palliative. A low threshold for suspecting skew deviations and prompt neuroimaging is in order. Abstruse presentations exist.
PRESENTATION NOT RECEIVED FROM THE AUTHOR.
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