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Abducens palsy as the initial symptom in a case of hypertrophic pachymeningitis with choked disc and systemic manifestations Sayoko Ogita 1 , Jun Sugasawa 1 , Tomohiko Etomi 1 , Hidehiro Oku 1 , Tsunehiko Ikeda 1 , Fumiharu Kimura 2 1Dept of Ophthalmol,Osaka Med Coll 2Div of Neurol,First Dept of Int Med,Osaka Med Coll pp.1797-1802
Published Date 2009/11/15
DOI https://doi.org/10.11477/mf.1410103021
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Abstract. Purpose:To report a case of hypertrophic pachymeningitis with abducens palsy as the initial manifestation. Case:A 67-year-old male presented with diplopia since the several weeks. He had been diagnosed with pulmonary tuberculosis 6 years before. Findings:Corrected visual acuity was 1.0 right and 1.2 left. Abducens paresis was present in the left eye. No intracranial lesion was detected by magnetic resonance imaging(MRI). Diplopia was relieved by wearing prism spectacles. He developed abducens palsy and impaired sursumduction in the right eye 4 months later. Vertigo,headache and convulsion developed another 4 months later followed by choked disc. Contrast-enhanced MRI led to the diagnosis of hypertrophic pachymeningitis. Pulsed corticosteroid therapy was followed by remission except left trochlear palsy. Conclusion:This case illustrates that ocular motor palsy with atypical clinical course may be due to hypertrophic pachymeningitis.


Copyright © 2009, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

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