Leukemic leptomeningeal carcinomatosis causing 4th and 6th nerve palsies

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Identifier Leukemic_4th_and_6th
Title Leukemic leptomeningeal carcinomatosis causing 4th and 6th nerve palsies
Subject Abnormal Range, Fourth Nerve Palsy, Sixth Nerve Palsy
Creator Daniel R. Gold, DO, Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, The Johns Hopkins School of Medicine
Description This is a 55-yo-man with CML that recurred as AML. Diagonal diplopia developed, and on examination he was found to have a partial right 6th nerve palsy, in addition to a left hypertropia that increased in right gaze, down gaze, and in left head tilt consistent with a left 4th nerve palsy. There was 10 degrees of excyclodeviation OS with double Maddox rod testing. MRI showed enhancement of the right 6th nerve, and he was ultimately diagnosed with leukemic leptomeningeal carcinomatosis. Upon looking down and to the right and left, there was a clear left superior oblique (SO) paresis. He also had a V-pattern esotropia, presumably given his right 6th NP + left SO palsy, as the tertiary action of the SO muscle is abduction (V-pattern esodeviation is typically seen with bilateral 4th nerve palsies).
Contributor Daniel R. Gold, D.O. Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery The Johns Hopkins School of Medicine
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2017
Type Image/MovingImage
Format video/mp4
Rights Management Copyright 2016. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E, SLC, UT 84112-5890
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Language eng
ARK ark:/87278/s63n5tg3
Setname ehsl_novel_gold
Date Created 2017-05-31
Date Modified 2018-01-22
ID 1251076
Reference URL https://collections.lib.utah.edu/ark:/87278/s63n5tg3
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