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Arachnoid cyst causing third cranial nerve palsy manifesting as isolated internal ophthalmoplegia and iris cholinergic supersensitivity.

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Title Journal of Neuro-Ophthalmology, September 2008, Volume 28, Issue 3
Publisher Lippincott, Williams & Wilkins
Date 2008-09
Type Text
Language eng
Rights Management © North American Neuro-Ophthalmology Society
Publication Type Journal Article
ARK ark:/87278/s6gj2q18
Setname ehsl_novel_jno
Date Created 2010-06-07
Date Modified 2020-03-03
ID 225739
Reference URL https://collections.lib.utah.edu/ark:/87278/s6gj2q18

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Title Arachnoid cyst causing third cranial nerve palsy manifesting as isolated internal ophthalmoplegia and iris cholinergic supersensitivity.
Creator Ashker, Lamees; Joel M. Weinstein, MD; Dias, Mark; Kanev, Paul; Nguyen, Dan; Bonsall, Dean J.
Affiliation Department of Ophthalmology, Penn State University, Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.
Subject Acetylcholine; ; Age Factors; Arachnoid Cysts; Cholinergic Fibers; Decompression, Surgical; Humans; Infant; Iris; Magnetic Resonance Imaging; Male; Muscarinic Agonists; Mydriasis; Neurosurgical Procedures; Oculomotor Muscles; Oculomotor Nerve; Oculomotor Nerve Diseases; Ophthalmoplegia; Parasympathetic Fibers, Postganglionic; Pilocarpine; Pupil Disorders; Treatment Outcome
Abstract An 8-month-old boy presented with anisocoria, a sluggishly reactive right pupil, and cholinergic supersensitivity as the only signs of what proved months later to be compressive third cranial nerve palsy due to an arachnoid cyst. Tonic constriction and dilation, segmental iris sphincter palsy, aberrant regeneration phenomena, ductional deficits, and ptosis were absent. The initial diagnosis was postganglionic internal ophthalmoplegia attributed to a viral ciliary ganglionopathy. Nineteen months later, he had developed an incomitant exodeviation and a supraduction deficit. Brain MRI revealed a mass consistent with an arachnoid cyst compressing the third cranial nerve in the right interpeduncular cistern. Resection of the cyst led to a persistent complete third cranial nerve palsy. This is the second reported case of prolonged internal ophthalmoplegia in a young child as a manifestation of a compressive third cranial nerve palsy. Our patient serves as a reminder that isolated internal ophthalmoplegia with cholinergic supersensitivity is compatible with a preganglionic compressive third nerve lesion, particularly in a young child.
OCR Text Show
Setname ehsl_novel_jno
Date Created 2010-06-07
Date Modified 2021-05-06
ID 225722
Reference URL https://collections.lib.utah.edu/ark:/87278/s6gj2q18/225722