$332 Wednesday, November 9, 2005 Poster Abstracts

Background: There are many spedfic symptoms in top of basilar syndrome. However, delayed continuous brmxism is not reported yet. Case: A 49-years man presented with quadriplegia and opthalomo- plegia. He diagnosed of sick sinus syndrome but did not take specific treatment. Brain MRI and M R angiography one day after the onset showed acute brain infarct in bilateral midbrain, right median thalamus and superior cerebellum with occ.lusion of distal basilar artery. One months later, patient started brtLxism and this symptom persisted during sleep. L-dopa treatment was not effective. Palatal myoclonus was not observed. Follow up MRI taken 4 month later showed bilateral olivary hypertrophy. Comment: Centeral pacemaker of brtLxism may locate in inferior olivary neucleus. Olivary hypertrophy can occur with brtLxism without palatal myoclonus.

0910 Tile etteets of Spatial and teinporal unee*tainty on tile generation of predictive saeeades

Anderson, T, Ko, D, MacAskill, M. Van der Veer Institute for Parkinson's and Brain Research, Christchurch, New Zealand

Background: When tracking a target moving rhytlmffcally between fixed positions, subjects normally produce anticipatory (predictive) saccades which have a much shorter latency than visually-guided saccades. We examined the limiting conditions under which predictive saccades are generated in nine neurologically healthy subjects. Method: In our control condition, two targets positioned 10 deg to the left and right of the mid-line were illuminated alternately for one of three fixed durations (1750 ms, 1400 ms and 2050 ms). We then applied several levels of spatial (0-8 deg) or temporal (0-30%) uncertainty to the above task. Thus, the targets appeared 0-8 deg either side of the expected positions or lasted shorter or longer than the expected durations by 0-30 %. Results: Longer target durations resulted in decreased anticipation of the target [F(2,16) -- 18.06, p < 0.0001], as did increased spatial [F(7,56) - 5.11, p < 0.0002] or temporal [F(5,30) - 7.51, p < 0.0002] uncertainty. Small amounts of spatial (_<1 deg) or temporal (_<10%) uncertainty had no effect on latency. Predictive saccades generated under the conditions of spatial uncertainty were characterised by hypomettic primary saccades, more pronounced at higher levels of uncertainty. Conclusions: These results demonstrate that small amounts of spatial uncertainty do not impair subjects" ability to generate predictive saccades, but the oculomotor strategy is to undershoot the target to minimise total sacc.adic flight time.

0911 Reversible external ophtahnoplegia: Idiopathic or a rosuvastatin side etl~ct: a ease report

Avramovic Gregoric j1, Gregoric E l, Jakovac F ~ Marolt 13. 1Dept. of Internal Medicbw, Hospital Izola, Slovenia, :Dept. of Radiology, Ortopedic Hospital Valdoltra, Slovenia, 3Diabetes outpatient clinic, Koper, Slovenia

We present a case of a 64 y old woman, who complained of a few weeks lasting painless horizontal diplopia. There was no difference between mornings and evenings in the severity of diplopia. There was no fanffly history of ophthalmoplegia. Results o f a general physical exanffnation were normal. She began taking rosuvastatin in october 2004 and tiffs was the only medication site was taking. After few weeks she began to complain of muscle weakness in the lower limbs while walking up the stairs. Then, a month later she suddenly developed diplopia. A MRI of the head was made but no pathology was found that could have caused diplopia. Neurological examination revealed no pathology except that the right ocular bulb was not following the left bulb in the leftward gaze. In the laboratory tests there was prominent tffperholesterolaemia in spite of rosuvastatin therapy

(total cholesterol 6.6, LDL 3.9, HDL 1.75, TRG 2.03). The values of the thyroide hormones were normal. Despite the high cholesterol values we stopped the rosuvastatin therapy. We should also emphasize that there was no effect on cholesterol values despite of a 3 month rosuvastatin therapy. After just one week without the statin, the diplopia reversed without any therapy. The MRI of the head was repeated and again it showed no prominent pathology. So, we can deduct, that rosuvastatin therapy causes reversible exetrnal ophtalmo- plegia and reversible diplopia is an important side effect not listed in the literature up till now, or we should search for other causes that could have caused the diplopia itself? Definitely is art issue that needs observation in the future.

0912 Oollomotor Palsy due to Midbrain Granulomas: Nuclear, Fasdcular or Mixed

Bhatia, R 1, Prasad, K 1, Padma, MV 1, Melton, S 1, Singh, MB 1, Kumar, R 1, Tripatlff, M 1, Srivatava, A 1 . ~All India Institute Of Medical Sciences, New Delhi, India

Introdnclion: Oculomotor palsy can result from a multitude of causes. Isolated focal granulomas of the brainstem are uncommon cause of oculomotor palsy. We report 2 cases of midbrain granulomas pre- senting with features of progressive third nerve palsy. Method: Case studies. Results: Casel: A 12 year old female presented with one week history of fever and headache followed 10 days later with ptosis of her left eye and diplopia. Symptoms progressed over next one week and ptosis deve- lopedin the right eye also. MRI scan of head showed conglomerate ring enhancing lesion in the central midbrain. She was further investigated and put on 4 drug ATT and steroids with significant improvement. Case2: An 8 yrs old male presented with a biphasic disease. In Feb" 04 he developed headache followed by ptosis in the left eye and later in right eye after 8-10 days. This was accompanied with diplopia but no other symptom. He was treated empirically by neostigmine without improvement and later had spontaneous remission. He presented to us two months later with similar symptoms again. CECT/MRI of the brain showed a discretely placed ring enhancing lesion with eccentric nodule within the midbrain with perilesional edema suggestive of a Cysticercus. The patient was treated with steroids with near resolution of symptoms and is on follow up. Conclusions: The present cases emphasize on importance of clinical localization and attatomical understanding of third nerve anatomy and highlight the importance of granulomatous lesions as etiological factors in our country. Anatomical aspects of localization shall be discussed.

0913 Trilateral Retinoblastoma- A rare case study

Dubey, TN, Sharma, VK, Gopal, R, Shrimali, R, Gopal, A, Dengra, A, Hiranandani, H, Satija, V, Rajarajan, T. Hamidia Hospital, Gandhi Medical College, Bhopal, India

Background: Retinoblastoma is the most common intraocular tumour of dffldhood, but ectopic retinoblastoma in pineal bodyt or parasellar region (Trilateral Retinoblastoma) is very rare. Retinoblastoma is highly malignant primary retinal tumour that arises from neuro- ectodermal cells that are destined to become retinal photoreceptors. Having common neuro-ectodermal origin, the pineal gland, if develops into a midline neuroblastic tumour, in a patient with bilateral retinoblastoma, probably representing an additional focus of muto- centric malignancy rather than metastatic disease. Method: A 2 year female child (born as full term normal delivery with no significant family history) presented to us with a huge mass and complete loss of vision in right eye, headache and vomiting. After complete biochemical, radiological and histopathological investiga- tions, enucleation was done for retinoblastoma and given adequate covet- of radiotherapy and chemotherapy. After 4 months, the mass