A very rare paroxysmal symptom in multiple sclerosis: convergence spasm

A case of convergence spasms - do not be caught off-guard

“…[3,4] Spasm of the near reflex is one cause for esotropia. Organic disorders causing esotropia include conditions such as abducens palsy, tonic convergence spasm (part of dorsal midbrain syndrome), pons lesions in multiple sclerosis, [5] myasthenia gravis and Wernicke's encephalopathy. [1] Patients with functional spasm of the near reflex have associated somatic complaints and behavioural abnormalities.…”

A case of convergence spasms - do not be caught off-guard

“…[3,4] Spasm of the near reflex is one cause for esotropia. Organic disorders causing esotropia include conditions such as abducens palsy, tonic convergence spasm (part of dorsal midbrain syndrome), pons lesions in multiple sclerosis, [5] myasthenia gravis and Wernicke's encephalopathy. [1] Patients with functional spasm of the near reflex have associated somatic complaints and behavioural abnormalities.…”

Paroxysmal Symptoms in Multiple Sclerosis—A Review of the Literature

“…Paroxysmal diplopia can be horizontal or vertical in nature depending on the underlying cause. Intermittent horizontal diplopia can be the result of recurrent episodes of bilateral eye adduction coupled with miosis [ 82 , 83 ], a condition known as convergence spasms. These paroxysms are believed to be provoked by irritation of the medial longitudinal fasciculus with lesions affecting the dorsomedial midbrain [ 83 ] and pons [ 82 ], among others [ 2 ].…”

“…Intermittent horizontal diplopia can be the result of recurrent episodes of bilateral eye adduction coupled with miosis [ 82 , 83 ], a condition known as convergence spasms. These paroxysms are believed to be provoked by irritation of the medial longitudinal fasciculus with lesions affecting the dorsomedial midbrain [ 83 ] and pons [ 82 ], among others [ 2 ]. Intermittent vertical diplopia owing to paroxysmal superior rectus and levator palpebrae spasm was described in the setting of a lesion affecting the third cranial nerve [ 84 ].…”