Oculomotor apraxia is a neurological disorder in which voluntary horizontal eye movements are impaired. Affected children cannot direct their eyes quickly and deliberately to a new point of gaze. Instead they develop striking compensatory movements with the head. The condition is usually recognised in the first months of life and frequently improves with increasing age.
Normally the eye can jump from one point to the next in a fraction of a second. These rapid eye movements are called saccades. In oculomotor apraxia, the regions of the brain that trigger and control these saccades are impaired. The eyes do not move to the desired target, or do so only with a delay.
Affected children develop a characteristic compensation strategy:
These rapid head movements (head saccades or head thrusts) are the most striking sign of the condition. Vertical eye movements (up and down) are generally not affected.
Head movements instead of quick eye movements can be assessed well in an examination of eye movements. Dr. Stefan Langenegger and orthoptist Edona Desku observe your child's gaze movements and coordinate the next steps with pediatric neurology if needed, at our practice near Zurich main station.
The diagnosis is made clinically, with the ophthalmologist or paediatric neurologist observing eye movements in various directions. Characteristic findings are the inability to perform rapid sideways gaze movements on request, together with the typical head movements. Depending on what is suspected, imaging (MRI) and genetic tests can be carried out in order to rule out accompanying conditions.
There is no specific treatment for oculomotor apraxia itself. Care includes:
Congenital oculomotor apraxia generally follows a favourable course. The head movements become more discreet over the years, and most children manage well in everyday life. The long-term prognosis depends substantially on whether accompanying neurological conditions are present.
