Complete Ophthalmoplegia
- 1 April 2008
- journal article
- case report
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 39 (4), 1355-1357
- https://doi.org/10.1161/strokeaha.107.504761
Abstract
Background and Purpose— Complete ophthalmoplegia, the combination of bilateral ptosis with loss of all extraocular movements, is rarely a consequence of ischemic stroke. We describe 3 patients who had complete ophthalmoplegia as a manifestation of bilateral paramedian midbrain-thalamic infarction, and we discuss possible pathophysiologic mechanisms. Summary of Cases— Three patients presented with coma. All had complete ophthalmoplegia that initially persisted despite improvement or fluctuation in their other deficits. MRI revealed bilateral paramedian midbrain-thalamic infarction. Two patients died, with the ophthalmoplegia remaining unchanged before death. The surviving patient had a progressive improvement in ocular abduction but persisting third nerve and vertical gaze palsies. Conclusions— Complete ophthalmoplegia is an unusual sign of bilateral paramedian midbrain-thalamic infarction. The ophthalmoplegia could result from combined third nerve, pseudoabducens, and vertical gaze palsies.This publication has 7 references indexed in Scilit:
- Bilateral Ocular ParalysisArchives of Neurology, 2007
- Bilateral ophthalmoplegia: an unusual sign of the top of the basilar artery syndromeNeurological Sciences, 1996
- Characteristics of antidromically identified oculomotor internuclear neurons during vergence and versional eye movementsJournal of Neurophysiology, 1994
- Ophthalmoplegia with bilateral ptosis secondary to midbrain hemorrhage. A case with clinical and radiologic correlationSurgical Neurology, 1994
- Thalamic infarctsNeurology, 1988
- Paramedian thalamic and midbrain infarcts: Clinical and neuropathological studyAnnals of Neurology, 1981
- “Top of the basilar” syndromeNeurology, 1980