Congenital ocular motor apraxia with torsional oscillations : a case report

Congenital ocular motor apraxia (C-OMA) is an infrequently reported eye movement disorder associated with malformation or delayed maturation of the brain. Patients with C-OMA are unable to initiate voluntary horizontal saccades. This results in characteristic head thrusts into the desired field of gaze to compensate for the lack of saccadic ability. Careful examination of an 8-year-old Hispanic male revealed uncoordinated eye movements, lack of voluntary saccades, head thrusts, and gross/fine motor delays all consistent with congenital ocular motor apraxia. Torsional oscillations that resembled rotary nystagmus were also present. These have not been previously reported in association with C-OMA. Because young patients with this condition may appear to have cortical blindness, C-OMA is an important differential to be aware of in making a diagnosis.