J Korean Ophthalmol Soc > Volume 48(12); 2007 > Article
Journal of the Korean Ophthalmological Society 2007;48(12):1736-1741.
DOI: https://doi.org/10.3341/jkos.2007.48.12.1736    Published online December 31, 2007.
A Case of Abducens Nerve Palsy and Disc Swelling Complicating Pregnancy-Induced Hypertension.
Kyung Min Lee, Young Hun Park, Se Yeop Lee, Young Chun Lee
1Department of Ophthalmology, College of Medicine, Catholic University, Gyeonggi, Korea. leeyc@cmcnu.or.kr
2Department of Ophthalmology, College of Medicine, Kei-Myung University, Daegue, Korea.
임신성 고혈압에 의한 유두부종과 외향신경 마비를 동반한 환자 1예
이경민1,박영훈1,이세엽2,이영춘1
Department of Ophthalmology, College of Medicine, Catholic University1, Gyeonggi, Korea Department of Ophthalmology, College of Medicine, Kei-Myung University2 Daegue, Korea
Correspondence:  Young Chun Lee, M.D.
Abstract
PURPOSE
Abducens nerve palsy complicating pre-eclampsia during pregnancy occurs very rarely. The authors describe right abducens nerve palsy, disc swelling, and hypertensive retinopathy found in both eyes of a pre-eclampsia patient. CASE SUMMARY: A 29-year-old woman, who was in her 31st week of gestation, was admitted to the hospital complaining chiefly of diplopia and abduction limitation in her right eye, which started suddenly 3 weeks prior to admission. Her condition was carefully followed up by a local clinic because this symptom of hypertension manifested one month before her admission to the local clinic. Brain MRI and laboratory tests were performed in order to exclude diseases of the central nervous system and/or other systemic diseases. An alternative prism cover test showed approximately 25PD (prism diopter) right esotropia, with -2 degrees abduction limitation observed in the patient's right eye. Both hypertensive retinopathy and papilledema were observed. Her blood pressure was 155/110 mmHg, and she had moderate proteinuria when she was admitted to the hospital. She was referred to an obstetrician and diagnosed as having pre-eclampsia. Other than pre-eclampsia with proteinuria, the brain imaging examination failed to reveal any particular findings, such as CNS disorders, including brain edema, cerebral infarction, or a brain tumor. In addition, systemic diseases which might have caused papilledema and abducens nerve palsy, including diabetes mellitus, were not evident in this case. Therefore, the patient was diagnosed with ischemic abducens nerve palsy and hypertensive retinopathy complicating moderate pre-eclampsia. The patient's diplopia and right eye abduction limitation were gradually relieved after parturition.
Key Words: Abducens nerve palsy;Hypertensive retinopathy;Papilledema;Pre-eclampsia


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