Paroxysmal Tonic Downgaze: A Pseudo Sunsetting Sign

A 30-day-old boy, born full-term, presented with a one day history of abnormal eye movements characterized by frequent, brief episodes of intermittent downgaze with vertical nystagmus that occurred while awake (Video/Figure). These episodes occurred both in supine and upright position without clear triggers. Neurological exam was otherwise normal. Increased intracranial pressure was considered due to similarity to the sunsetting eye sign, although our patient had preserved upgaze, and his downgaze was intermittent but not persistent.

Source: The Journal of Pediatrics - December 8, 2020 Category: Pediatrics Authors: Deepa Sirsi, Dallas Armstrong Tags: Insights and Images Source Type: research