case_images: PMC11017011_01
case_images: The directions of gaze at the first presentation are illustrated on the right-side table. The figure shows a complete loss of right and left eye movement in straight, up, and down gaze. Also, it shows a slight limitation in vertical eye movement
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case_images: sjopt_106_23-f001
case_images: EOM showed a complete bilateral loss of abduction and adduction, with a slight limitation of supraduction and infraduction in both eyes [Figure 1].
case_images: Multiple sections of axial T2/fluid-attenuated inversion recovery magnetic resonance imaging of the brain, showing multiple hyperintense lesions of varying sizes in the centrum semiovale (a and c), and the periventricular white matter (b)
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case_images: PMC11017011_01_SJO-38-59-g002.jpg
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case_images: Moreover, none of the lesions showed enhancement and were considered inactive lesions [Figures 2 and 3].
case_images: Axial T2-weighted magnetic resonance imaging (MRI) of the brain. (a) A hyperintense lesion in the dorsal and lateral pons (yellow arrow) and multiple hyperintense lesions of the middle cerebral peduncles (white arrows), more pronounced on the left side. The same lesions are illustrated at different levels with T2/fluid-attenuated inversion recovery MRI in photos (b and c)
case_images: SJO-38-59-g003.jpg
case_images: PMC11017011_01_SJO-38-59-g003.jpg
case_images: sjopt_106_23-f003
case_images: Moreover, none of the lesions showed enhancement and were considered inactive lesions [Figures 2 and 3].
case_images: The nine gazes 1 month after botulinum toxoid injection. The photo shows a full recovery of extraocular motility in all directions of gaze, as illustrated in the table on the right
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case_images: PMC11017011_01_SJO-38-59-g004.jpg
case_images: sjopt_106_23-f004
case_images: Following up after 1 month, she significantly improved, and she was orthotropic with full correction [Figure 4], and there was no need to repeat the injection.