Year: 2008
Type: article
Study design: Case Report
Abstract: A 41-year-old patient developed diplopia, imbalance, and weight loss.Examination showed pendular vergence oscillations of the eyes and synchronous contractions of the masticatory but not palatal muscles, i.e., oculomasticatory myorhythmia (OMM; figure).There was complete supranuclear vertical and, to a lesser extent, horizontal gaze palsy.The remainder of the examination was unremarkable.Brain MRI was normal.OMM is pathognomonic of Whipple disease. 1 In its presence, neither jejunal biopsy nor blood or CSF PCR of Tropheryma whippelii is necessary for the initiation of trimethoprim-sulfamethoxazole. 2 This patient became symptom free after 6 months of treatment.Video footage of the typical presentation should assist clinicians in recognizing this highly treatable neurologic disorder.
Source: Neurology
Authors: Fredy J. Revilla, Rafael de la Cruz, Nancy Khardori, Alberto J. Espay
Institutions: SIU Medicine, University of Cincinnati
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1985416203