| Pituitary Apoplexy Presenting as Isolated Bilateral Oculomotor Nerve Palsy. |
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Heejung Cho, Young Jin Song, Won Yeol Ryu |
1Department of Ophthalmology, Dong-A University College of Medicine, Busan, Korea. wyryu@dau.ac.kr
2Department of Neurosurgery, Dong-A University College of Medicine, Busan, Korea. |
| 뇌하수체졸중환자에서 발생한 단독 양측 동안신경마비 |
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조희정1 · 송영진2 · 류원열1 |
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동아대학교 의과대학 안과학교실1, 동아대학교 의과대학 신경외과학교실2 |
Correspondence:
Won Yeol Ryu,
Email: wyryu@dau.ac.kr
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Received: 21 March 2019 • Revised: 17 April 2019 • Accepted: 24 September 2019 |
| Abstract |
PURPOSE
To report a case of pituitary apoplexy presenting as isolated bilateral oculomotor nerve palsy. CASE SUMMARY: A 46-year-old male presented with bilateral ptosis and acute severe headaches for 6 days. He underwent head surgery and bilateral vitrectomy 12 years prior to his visit because of ocular and head trauma. He mentioned that previous visual acuities in both eyes were not good. The initial corrected visual acuity was finger counting in the right eye and 20/500 in the left eye. Ocular motility testing revealed the limitation of adduction, supraduction, and infraduction with complete bilateral ptosis in both eyes, and his left pupil was dilated. He was diagnosed with an isolated bilateral oculomotor nerve palsy. Magnetic resonance imaging indicated pituitary gland hemorrhage with a tumor, which was suspicious of pituitary apoplexy. The patient was treated intravenous with 1.0 g methylprednisolone to prevent the corticotropic deficiency. In addition, he underwent surgical decompression using a navigation-guided transsphenoidal approach and aspiration biopsy. He was confirmed with pituitary adenoma using a pathological examination. The patient's ocular movements began to dramatically improve by the third day postoperatively. At 4 months postoperative follow-up, his ocular movement and double vision were completely recovered. CONCLUSIONS: This was a rare case of pituitary apoplexy with bilateral isolated oculomotor nerve palsy, which was the first report in the Republic of Korea. A full recovery was achieved after early surgical treatment. |
| Key Words:
Cranial nerve palsy;Oculomotor nerve disease;Oculomotor nerve palsy;Pituitary adenoma;Pituitary apoplexy |
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