Acute Convergence and Divergence Paralysis in HIV-Related Rhombencephalitis

Acute vergence disorders might be caused by CNS disease. Acute divergence paralysis has been associated with thalamic stroke, elevated intracranial hypertension, Miller-Fisher syndrome, and nucleus reticularis tegmenti pontis (NRTP) lesions, while acute convergence paralysis has been related to lesions in the corpora quadrigemina, cerebellar peduncles, rostral superior colliculus, third nerve nucleus, frontal eye field and the NRTP. Simultaneous acute divergence and convergence paralysis in the presence of CNS disease is extremely rare. We present a case of acute convergence and divergence paralysis, in a patient with an HIV-related pontine lesion involving the NRTP.