Chou T M, Demer J L
Department of Ophthalmology, University of California, Los Angeles, USA.
Am J Ophthalmol. 1998 Nov;126(5):737-40. doi: 10.1016/s0002-9394(98)00139-1.
To report a case of isolated inferior rectus palsy secondary to a metastasis to the oculomotor nucleus.
Case report. A 41-year-old woman with a history of breast cancer presented with acute onset of left hypotropia and exotropia.
Forced generation testing confirmed weakness of the right inferior rectus muscle that was not reversed by intravenous edrophonium infusion. Magnetic resonance imaging disclosed numerous metastatic lesions to the cerebral hemispheres and brainstem. One lesion in the right midbrain was adjacent to the cerebral aqueduct in the right oculomotor nucleus.
Metastasis to the oculomotor nucleus is a rare cause of isolated inferior rectus palsy; however, this entity should be considered in the differential diagnosis of an isolated inferior rectus palsy because of the life-threatening consequences of a brainstem lesion.
报告一例因动眼神经核转移导致的孤立性下直肌麻痹病例。
病例报告。一名有乳腺癌病史的41岁女性，出现急性左眼下斜视和外斜视。
强迫性眼球运动试验证实右眼下直肌无力，静脉注射依酚氯铵后无改善。磁共振成像显示大脑半球和脑干有多处转移病灶。右中脑的一个病灶毗邻右侧动眼神经核处的大脑导水管。
动眼神经核转移是孤立性下直肌麻痹的罕见病因；然而，鉴于脑干病变可能危及生命，在孤立性下直肌麻痹的鉴别诊断中应考虑这一病因。
