Biomedical subjects
Publications and source records attributed to W C Robertson.
Isolated oculomotor nerve palsy is an unusual finding in the pediatric patient. Third nerve weakness is a rare complication of vascular headaches, and there are few reported cases of so-called ophthalmoplegic migraine (OM) in young children. Recently we have seen a 12-month-old girl with OM that appeared to respond to treatment with propranolol.
We have used computerized tomography (CT) to look for evidence of cerebral demyelination in children with progressive neurologic disorders. Fourteen patients with a clinical diagnosis of a demyelinating disorder were examined by CT, and five had CT findings suggesting cerebral demyelination. In two patients with a so-called myelinoclastic demyelinating disease, CT showed asymmetric, circumscribed areas of diminished radiodensity, and in three patients with a leukodystrophy, scans showed diffuse symmetric areas of low density in the centrum ovale. Autopsy examination in one patient confirmed the diagnosis of sudanophilic leukodystrophy and substantiated the abnormalities suspected from CT.
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Of 115 patients with acute intermittent porphyria seen during a 20-year period, 11 had experienced an acute episode of quadriparesis. Nerve conduction studies performed on 8 of these 11 patients showed low-amplitude compound action potentials and normal velocity measurements. Needle electromyography demonstrated prominent fibrillation potentials, especially in proximal muscles. The changes in these findings with time confirm that this disorder is an acute axonal neuropathy.