Bimedial rectus hypermetabolism in convergence spasm as observed on positron emission tomography

J Neuroophthalmol. 2008 Sep;28(3):217-8. doi: 10.1097/WNO.0b013e3181772b02.

Abstract

A 52-year-old man developed vertical gaze palsy, convergence spasm, and convergence-retraction nystagmus due to glioblastoma of the right thalamus. 18F-fluorodeoxyglucose positron emission tomography (PET) inadvertently demonstrated markedly increased metabolism in the medial rectus muscles. The hypermetabolism indicates active contraction of these extraocular muscles due to excessive convergence drive attributed to inappropriate activation or disrupted inhibition of convergence neurons by the diencephalic lesion.

Publication types

  • Case Reports

MeSH terms

  • Brain Neoplasms / complications*
  • Brain Neoplasms / pathology
  • Energy Metabolism / physiology
  • Esotropia / etiology
  • Esotropia / pathology
  • Esotropia / physiopathology
  • Eye Movements / physiology
  • Glioblastoma / complications*
  • Glioblastoma / pathology
  • Humans
  • Hydrocephalus / etiology
  • Hydrocephalus / pathology
  • Hydrocephalus / physiopathology
  • Male
  • Middle Aged
  • Muscle Contraction / physiology
  • Neural Inhibition / physiology
  • Neural Pathways / pathology
  • Neural Pathways / physiopathology
  • Ocular Motility Disorders / diagnostic imaging*
  • Ocular Motility Disorders / etiology
  • Ocular Motility Disorders / physiopathology
  • Oculomotor Muscles / diagnostic imaging*
  • Oculomotor Muscles / physiopathology
  • Positron-Emission Tomography
  • Spasm / diagnostic imaging*
  • Spasm / etiology
  • Spasm / physiopathology
  • Syndrome
  • Tegmentum Mesencephali / pathology
  • Tegmentum Mesencephali / physiopathology
  • Thalamic Diseases / complications*
  • Thalamic Diseases / pathology
  • Thalamus / pathology
  • Thalamus / physiopathology