Unilateral Abducens Nerve Palsy in Increased Intracranial Pressure Caused by Brain Neoplasm
Article Outline
Abstract
A 45-year-old woman with a 2-year history of chronic headaches and intermittent transient obscured vision presented with acute onset of diplopia for 2 weeks. Ophthalmologic examination showed esotropia due to right abducens nerve palsy and bilateral chronic papilledema. Brain magnetic resonance imaging demonstrated a meningioma in the left parasagittal frontal region causing a right shift of the anterior midline and compression of the lateral ventricle. The tumor was completely removed and her diplopia and esotropia disappeared. At the 2-month follow-up, papilledema had subsided. Acute onset of esotropia resulting from right abducens nerve palsy may be an ominous sign of brain tumor.
keywords: Abducens nerve palsy , Esotropia , Increased intracranial pressure (IICP) , Meningioma
No full text is available. To read the body of this article, please view the PDF online.
References
- . Diplopia in a patient with carcinomatous meningitis . J Emerg Med . 2002;23:351–354
- . A bruital headache and double vision . Surv Ophthalmol . 2000;45:147–153
- . Infarction of abducens nerve fascicle as cause of isolated sixth nerve palsy related to hypertension . Neurology . 1988;38:1654–1660
- Ischemic and hemorrhagic brain stem lesions mimicking diabetic ophthalmoplegia . Clin Neurol Neurosurg . 1995;97:167–171
- . Isolated abducens nerve palsy from pontine infarction in a diabetic patient . Neurology . 1992;42:2226–2230
- . Isolated abducens nerve paresis from intrapontine, fascicular abducens nerve injury . Am J Ophthalmol . 1989;108:459–461
- Isolated sphenoid sinusitis presenting with unilateral VIth nerve palsy . Int J Ped Otorhinolaryngol . 2004;68:507–510
- Long-term prognosis in patients with vasculopathic sixth nerve palsy . Am J Ophthalmol . 2002;134:81–84
- Incidence, asso ciations, and evaluation of sixth nerve palsy using a population-based method . Ophthalmology . 2004;111:369–375
- . Cause and prognosis of nontraumatic sixth nerve palsies in young adults . Ophthalmology . 2002;109:1925–1928
- . Acute comitant esotropia: a sign of intracranial disease . Can J Ophthalmol . 1994;29:151–154
- . Acute onset concomitant esotropia: when is it a sign of serious neurological disease? . Br J Ophthalmol . 1995;79:498–501
- . Supranuclear disorders of ocular control systems in man . In: Bach-y-Rita P editors. The Control of Eye Movements . New York: New York Academic Press; 1971;
- . Acquired 6th nerve paresis in children . Arch Ophthalmol . 1970;83:574–579
- . Acute esotropia may be a presenting sign of intracranial neoplasm . Kaohsiung J Med Sci . 1998;14:710–716
- . Anatomy and embryology of the ocular motor system . In: Miller NR , Newman NJ editor. Clinical Neuro-Ophthalmology . 5th edition. Baltimore: Williams & Wilkins; 1998; Chapter 25.
- . Acute isolated sphenoid sinusitis: a disease with complications . J Laryngol Otol . 1991;105:1072–1074
- . Isolated sphenoid lesions: diagnosis and management . Otolaryngol Head Neck Surg . 1999;120:730–736
- . Complications of lumbar puncture . Neurol Clin . 1998;16:83–105
- . Abducens palsy after lumbar puncture . Clin Neurol Neurosurg . 2002;104:61–63
- Isolated bilateral sixth nerve palsy secondary to metastatic carcinoma: a case report with a review of the literature . Clin Neurol Neurosurg . 2003;106:51–55
- . Papilledema . In: Miller NR , Newman NJ editor. Clinical Neuro-Ophthalmology . 5th edition. Baltimore: Williams & Wilkins; 1998; Chapter 10.
- . Neuro-ophthalmologic evaluation of abducens nerve paralysis . Arch Ophthalmol . 1960;63:108–115
PII: S1016-3190(10)60025-0
doi:10.1016/S1016-3190(10)60025-0
© 2007 Buddhist Compassion Relief Tzu Chi Foundation. Published by Elsevier Inc. All rights reserved.
