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Bilateral oculomotor nerve palsy due to chronic hypertension: A case report

Year 2014, , 177 - 179, 01.05.2014
https://doi.org/10.5505/abantmedj.2014.44227

Abstract

Cranial nerve palsies are frequently encountered in the course of systemic diseases. However, the third cranial oculomotor nerve palsy secondary to hypertension is very rare. A 72-year-old woman presented with a complaint of proptosis of the eyes bilaterally. In her neuro-ophthalmic examination, isolated bilateral oculomotor nerve palsy was detected. Blood tests and neuroradiological imaging were within normal limits. A lumbar puncture was non-spesific. Regarding laboratory and electrophysiological results, the possible myasthenic aetiology was excluded. Together with these findings, the patient was considered to have ischemic cranial neuropathy developed secondary to chronic hypertension.

References

  • 1. Wong TY, Mitchell P.The eye in hypertension. Lancet 2007;369:425-435.
  • 2. Jacobson DM, McCanna TD, Layde PM. Risk factors for ischemic ocular motor nerve palsies. Arch Ophthalmol 1994;112:961-966.
  • 3. Appenzeller S, Veilleux M, Clarke A. Third cranial nerve palsy or pseudo 3rd nerve palsy of myasthenia gravis? A challenging diagnosis in systemic lupus erythematosus. Lupus 2009;18:836-840.
  • 4. Motoyama Y, Nonaka J, Hironaka Y, Park YS, Nakase H. Pupil-sparing oculomotor nerve palsy caused by upward compression of a large posterior communicating artery aneurysm. Case report. Neurol Med Chir (Tokyo) 2012;52:202-205.
  • 5. Jacobson DM. Pupil involvement in patients with diabetes-associated oculomotor nerve palsy. Arch Ophthalmol 1998;116:723-727.
  • 6. Blake PY, Mark AS, Kattah J, Kolsky M. MR of oculomotor nerve palsy. AJNR Am J Neuroradiol 1995;16:1665-1672.
  • 7. Lazaridis C, Torabi A, Cannon S. Bilateral third nerve palsy and temporal arteritis. Arch Neurol 2005;62:1766-1768.
  • 8. Tan H. Bilateral oculomotor palsy secondary to pseudotumor cerebri. Pediatr Neurol 2010; 42:141-142.
  • 9. Bonebrake RG, Fleming AD, Carignan EM, Hoover DK. Severe preeclampsia presenting as third nerve palsy. Am J Perinatol 2004;21:153- 155.
  • 10. Vaphiades MS, Bhatti MT, Lesser RL. Ocular myasthenia gravis. Curr Opin Ophthalmol 2012;23:537-542.

Bilateral okülomotor sinir paralizisi gelişen kronik hipertansif bir olgu

Year 2014, , 177 - 179, 01.05.2014
https://doi.org/10.5505/abantmedj.2014.44227

Abstract

Sistemik hastalıkların seyrinde kraniyal sinir paralizilerine sıkça rastlanmaktadır. Ancak hipertansiyona sekonder üçüncü kraniyal okülomotor sinir paralizisi oldukça nadirdir. 72 yaşında bayan hasta iki taraflı göz kapaklarında düşüklük şikayeti ile başvurdu. Hastanın nöro-oftalmik muayenesinde, izole bilateral okülomotor sinir paralizisi mevcuttu. Kan tahlilleri ve nöroradyolojik görüntülemesi normal sınırlarda idi. Lomber ponksiyonda bir özellikle saptanmadı. Laboratuvar ve elektrofizyolojik sonuçlara göre olası myastenik bir etyoloji dışlandı. Bu bulgularla hastamızda, kronik hipertansiyona sekonder iskemik kraniyal nöropati geliştiği kabul edildi.

References

  • 1. Wong TY, Mitchell P.The eye in hypertension. Lancet 2007;369:425-435.
  • 2. Jacobson DM, McCanna TD, Layde PM. Risk factors for ischemic ocular motor nerve palsies. Arch Ophthalmol 1994;112:961-966.
  • 3. Appenzeller S, Veilleux M, Clarke A. Third cranial nerve palsy or pseudo 3rd nerve palsy of myasthenia gravis? A challenging diagnosis in systemic lupus erythematosus. Lupus 2009;18:836-840.
  • 4. Motoyama Y, Nonaka J, Hironaka Y, Park YS, Nakase H. Pupil-sparing oculomotor nerve palsy caused by upward compression of a large posterior communicating artery aneurysm. Case report. Neurol Med Chir (Tokyo) 2012;52:202-205.
  • 5. Jacobson DM. Pupil involvement in patients with diabetes-associated oculomotor nerve palsy. Arch Ophthalmol 1998;116:723-727.
  • 6. Blake PY, Mark AS, Kattah J, Kolsky M. MR of oculomotor nerve palsy. AJNR Am J Neuroradiol 1995;16:1665-1672.
  • 7. Lazaridis C, Torabi A, Cannon S. Bilateral third nerve palsy and temporal arteritis. Arch Neurol 2005;62:1766-1768.
  • 8. Tan H. Bilateral oculomotor palsy secondary to pseudotumor cerebri. Pediatr Neurol 2010; 42:141-142.
  • 9. Bonebrake RG, Fleming AD, Carignan EM, Hoover DK. Severe preeclampsia presenting as third nerve palsy. Am J Perinatol 2004;21:153- 155.
  • 10. Vaphiades MS, Bhatti MT, Lesser RL. Ocular myasthenia gravis. Curr Opin Ophthalmol 2012;23:537-542.
There are 10 citations in total.

Details

Primary Language Turkish
Journal Section Case Report
Authors

Asuman Çelikbilek This is me

Mehmet Adam This is me

Aylin Okur This is me

Publication Date May 1, 2014
Published in Issue Year 2014

Cite

APA Çelikbilek, A., Adam, M., & Okur, A. (2014). Bilateral okülomotor sinir paralizisi gelişen kronik hipertansif bir olgu. Abant Medical Journal, 3(2), 177-179. https://doi.org/10.5505/abantmedj.2014.44227
AMA Çelikbilek A, Adam M, Okur A. Bilateral okülomotor sinir paralizisi gelişen kronik hipertansif bir olgu. Abant Med J. May 2014;3(2):177-179. doi:10.5505/abantmedj.2014.44227
Chicago Çelikbilek, Asuman, Mehmet Adam, and Aylin Okur. “Bilateral okülomotor Sinir Paralizisi gelişen Kronik Hipertansif Bir Olgu”. Abant Medical Journal 3, no. 2 (May 2014): 177-79. https://doi.org/10.5505/abantmedj.2014.44227.
EndNote Çelikbilek A, Adam M, Okur A (May 1, 2014) Bilateral okülomotor sinir paralizisi gelişen kronik hipertansif bir olgu. Abant Medical Journal 3 2 177–179.
IEEE A. Çelikbilek, M. Adam, and A. Okur, “Bilateral okülomotor sinir paralizisi gelişen kronik hipertansif bir olgu”, Abant Med J, vol. 3, no. 2, pp. 177–179, 2014, doi: 10.5505/abantmedj.2014.44227.
ISNAD Çelikbilek, Asuman et al. “Bilateral okülomotor Sinir Paralizisi gelişen Kronik Hipertansif Bir Olgu”. Abant Medical Journal 3/2 (May 2014), 177-179. https://doi.org/10.5505/abantmedj.2014.44227.
JAMA Çelikbilek A, Adam M, Okur A. Bilateral okülomotor sinir paralizisi gelişen kronik hipertansif bir olgu. Abant Med J. 2014;3:177–179.
MLA Çelikbilek, Asuman et al. “Bilateral okülomotor Sinir Paralizisi gelişen Kronik Hipertansif Bir Olgu”. Abant Medical Journal, vol. 3, no. 2, 2014, pp. 177-9, doi:10.5505/abantmedj.2014.44227.
Vancouver Çelikbilek A, Adam M, Okur A. Bilateral okülomotor sinir paralizisi gelişen kronik hipertansif bir olgu. Abant Med J. 2014;3(2):177-9.