Recurrent contralateral abducens nerve palsy in acute unilateral sphenoiditis. Am J Otolaryngol 2010;31(5):372-5
Date
12/18/2009Pubmed ID
20015769DOI
10.1016/j.amjoto.2009.03.003Scopus ID
2-s2.0-77956226904 (requires institutional sign-in at Scopus site) 11 CitationsAbstract
OBJECTIVE: We describe a patient who presented with recurrent, contralateral abducens nerve palsy resulting from acute sphenoiditis.
METHODS: Patient medical record and imaging studies were reviewed. A literature review of complications of sphenoiditis was performed.
RESULTS: Our patient presented with symptoms consistent with an upper respiratory tract infection, as well as severe headache, disequilibrium, and diplopia. Physical examination demonstrated left-sided sixth cranial nerve palsy. Imaging studies were consistent with right sphenoid sinus inflammatory disease. Her medical history was significant for a similar episode 9 years previously, which was managed medically. The current episode was treated acutely with antibiotics and prednisone. Upon resolution of her symptoms, she underwent an endoscopic sphenoidotomy.
CONCLUSIONS: Although cranial nerve palsies associated with isolated sphenoiditis have been reported, we describe a unique case of recurrent isolated sphenoiditis causing contralateral abducens nerve palsy. Acute management can be medical, with surgical therapy reserved for refractory cases or to prevent future episodes.
Author List
Gupta N, Michel MA, Poetker DMAuthors
Michelle A. Michel MD Adjunct Professor in the Radiology department at Medical College of WisconsinDavid M. Poetker MD Chief, Professor in the Otolaryngology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Abducens Nerve DiseasesAcute Disease
Amoxicillin-Potassium Clavulanate Combination
Anti-Bacterial Agents
Anti-Inflammatory Agents
Diplopia
Female
Headache
Humans
Magnetic Resonance Imaging
Middle Aged
Postural Balance
Prednisone
Recurrence
Sphenoid Sinus
Sphenoid Sinusitis
Tomography, X-Ray Computed
