J Korean Ophthalmol Soc > Volume 56(8); 2015 > Article
Journal of the Korean Ophthalmological Society 2015;56(8):1300-1303.
DOI: https://doi.org/10.3341/jkos.2015.56.8.1300    Published online August 15, 2015.
A Case of Isolated Third Nerve Palsy with Preeclampsia.
Jang Hoon Lee, Yoon Jae Wi, Yeon Ju Choi
Department of Ophthalmology, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. ophdrchoi@gmail.com
자간전증과 동반된 동안신경마비 1예
이장훈⋅위윤재⋅최연주
한림대학교 의과대학 한림대학교강동성심병원 안과학교실
Received: 20 March 2015   • Revised: 24 April 2015   • Accepted: 1 July 2015
Abstract
PURPOSE
Isolated oculomotor nerve palsy in preeclampsia patients have not been reported in Korea. Herein, we report 1 case of a patient in her 32nd week of gestation diagnosed with preeclampsia experiencing oculomotor nerve palsy in the left eye which improved after delivery. CASE SUMMARY: 28-year-old pregnant woman in her 32nd week of gestation with no underlying diseases visited our clinic with the chief complaint of diplopia and left eye ptosis. The patient suffered headache symptoms 1 week prior and did not undergo any exams. The visual acuity, anterior segment, and, fundus showed no abnormal signs and the pupil light reflex was normal, but the patient showed left eye ptosis with +2 mm/-2 mm on the marginal reflex distance (MRD) exam, 25 prism exotropia and 6 prism hypotropia, supraduction and adduction limitation -2 and, infraduction limitation -1. To exclude other systemic disorders and brain lesions, laboratory tests and brain magnetic resonance imaging (MRI) was performed, and preeclampsia was diagnosed based on high blood pressure (150/110 mm Hg) and mild proteinuria. Imaging and labatory tests showed other disorders thus the patient was treated conservatively. Two weeks after the ocular symptoms appeared, the left ptosis and ocular movement restriction worsened, but systemic signs and tests shown no aggravation, thus we maintained conservative therapy and after delivery at 37-weeks, the symptoms slowly improved and recovered completely after 2 months. CONCLUSIONS: Full systemic examination including MRI and laboratory tests must be performed in pregnant women who suddenly experience ocular symptoms and are diagnosed as oculomotor motor nerve palsy. If diagnosis and treatment are appropriate, good prognosis can be expected in this disease.
Key Words: Oculomotor nerve palsy;Preeclampsia;Third nerve palsy


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