Journal of Neuro-Ophthalmology, June 1986, Volume 6, Issue 2

Peripheral ophthalmoplegia as the only sign of late-onset fibrous dysplasia of the skull.

A 49-year-old woman presented with a left eye abduction-elevation defect and a bilateral internal rectus palsy of peripheral origin. Thyroid function, cranial computed tomographic scan, and cerebrospinal fluid examination were normal, as were the prostigmine test for myasthenia gravis and the guanidine hydrochloride test for myasthenic syndrome. Skull radiography showed osteosclerotic and osteolytic areas, with slight orbital distortion, and there was hyperactivity in an isotopic scan. A skill biopsy showed fibrous dysplasia. This case is an unusual example of fibrous dysplasia of the skull with neuro-ophthalmological symptoms but without ptosis, exophthalmos, or visual loss.