DR. DEEPTHI R

Dr.K Kalaivani, Dr.SARANYA BALAKRISHNAN, Dr. Amala Reji

Abstract

A 27yr male,came with complaints of sudden onset binocular,horizontal diplopia for 5 days worsening on left gaze,History of dysphagia 5 days.He was diagnosed as TB cervical lymphadenitis,on ATT past 5 months.He was known case of type1diabetes mellitus since 9 years,on treatment.Examination showed:left sided face turn,anterior segment and fundus examination were normal in Right eye.Left eye showed 15 degree esotropia,normal anterior segment with abduction restriction(-4),normal fundus examination.Visual acuity 6/6 in both eyes.Colour vision and Corneal sensation normal in both eye.Other cranial nerves examination were normal.MRI neck and brain showed large diffuse suprahyoid neck mass involving oropharynx and nasopharynx with intracranial extension in prepontine cistern and cavernous sinus.Diagnosed as left lateral rectus palsy due to parapharyngeal mass and referred to oncologist.This case emphasize importance of neurological evaluation with imaging in an isolated cranial nerve palsy.