Transient tonic upgaze deviation: a neuro-ophthalmological complication of acute cerebellitis.

Acute cerebellitis in children is an inflammatory syndrome with symptoms of cerebellar dysfunction. We describe a 3-year-old boy with acute cerebellitis who had cerebellar tonsillar herniation, hydrocephalus, and transient tonic bilateral upward gaze deviation. Although no etiology for his acute cerebellitis was determined, he fully recovered with high-dose corticosteroids, intravenous immunoglobulin, and antimicrobial therapy. We propose that there was tonic irritation of the upward gaze generator cells in the superior colliculus as an explanation for temporary disturbance of his ocular gaze.