MESENCEPHALIC CLEFTS WITH ASSOCIATED EYE-MOVEMENT DISORDERS

Objective: To describe two patients with mesencephalic midline clefts and associated eye movement disorders. Design: Case reports. Results: The first patient developed bilateral internuclear ophthalmoplegia wit h exotropia, reduced convergence, right ptosis, right fourth-nerve pal sy, and right elevator palsy several years after meningitis with hydro cephalus. The second patient had bilateral internuclear ophthalmoplegi a with exotropia, reduced convergence, bilateral ptosis, limited upwar d gaze, and right hypertropia since childhood. In both patients, magne tic resonance imaging showed a midline cleft extending from the cerebr al aqueduct into the midbrain. Conclusion: It is likely that the cleft s affected the oculomotor nuclei and medial longitudinal fasciculi, ac counting for the eye movement disorders.