Developmental Medicine & Child Neurology



Original Articles

Neurodevelopmental implications of ocular motor apraxia


JE Marr  a1, SH Green  a2 and HE Willshaw  a2 c1
a1 Hallamshire Hospital, Sheffield, UK.
a2 Department of Paediatric Neuro-Ophthalmology, Children's Hospital, Birmingham, UK.

Abstract

Ocular motor apraxia (OMA), a disorder of saccadic initiation, may be congenital or acquired. While the acquired form is frequently associated with significant neuropathology, the congenital form is often regarded as relatively benign. Many children with congenital OMA who were observed clinically have shown neurodevelopmental disturbance over time. A retrospective review was taken of 34 consecutive patients (22 males and 12 females), seen over a 20-year period, to evaluate the frequency and type of associated neurodevelopmental problems. Age at presentation ranged from 8 weeks to 14 years, with a mean age of 10 years. Of 29 children with congenital OMA, 15 had imaging evidence of structural central nervous system abnormalities (with cerebellar hypoplasia the most frequent abnormality detected). Eleven of the 14 patients with no structural abnormality showed abnormal neurodevelopment. This study suggests that congenital OMA is not a benign diagnosis, even in the absence of overt neurological disturbance at the time of presentation.

(Accepted December 14 2004)


Correspondence:
c1 Department of Paediatric Neuro-Ophthalmology, Children's Hospital, Birmingham B4 6NH, UK. E-mail: harry.willshaw@bch.nhs.uk