Paroxysmal Horizontal Diplopia Related to Brainstem Lesion

ABSTRACT

Paroxysmal diplopia and dysarthria-ataxia have been reported in multiple sclerosis, stroke and Behcet's disease. We present a case of 25-year-old man with multiple brain lesions, who developed paroxysmal horizontal dysconjugate eyeball deviation, dysarthria and ataxia. Subtraction ictal SPECT co-registered to MR images demonstrated hyperperfusion in the brainstem and cerebellum during the paroxysms.