• Journal of Trauma and Injury
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• v.21 no.1
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• pp.66-69
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• 2008

Traumatic bilateral abducens nerve palsy is rare and is associated with intracranial, skull and cervical spine injuries. We report a case of bilateral abducens nerve palsy in a 40-month-old patient with a skull base fracture. The injury mechanism was associated with direct nerve injury caused by a right petrous bone fracture and indirect injury by frontal impact on the abducens nerve at the point of fixation to the petrous portion and Dorello's canal. The emergency physician should be aware of injuries and the mechanism of abducens nerve palsy in head trauma.

• Journal of Korean Neurosurgical Society
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• v.44 no.6
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• pp.396-398
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• 2008

Although the incidence of unilateral abducens nerve palsy has been reported to be as high as 1% to 2.7% of head trauma cases, bilateral abducens nerve palsy following trauma is extremely rare. In this report, we present the case of a patient who developed a bilateral abducens nerve palsy and hypoglossal nerve palsy 3 days after suffering head trauma. He had a Glasgow Coma Score (GCS) of 15 points. Computed tomography (CT) images demonstrated clivus epidural hematoma and subarachnoid hemorrhage on the basal cistern. Herein, we discuss the possible mechanisms of these nerve palsies and its management.

• Journal of Korean Neurosurgical Society
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• v.53 no.2
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• pp.112-114
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• 2013

Bilateral abducens nerve palsy related to ruptured aneurysm of the anterior communicating artery (ACoA) has only been reported in four patients. Three cases were treated by surgical clipping. No report has described the clinical course of the isolated bilateral abducens nerve palsy following ruptured ACoA aneurysm obliterated with coil. A 32-year-old man was transferred to our institution after three days of diplopia, dizziness and headache after the onset of a 5-minute generalized tonic-clonic seizure. Computed tomographic angiography revealed an aneurysm of the ACoA. Magnetic resonance imaging showed focal intraventricular hemorrhage without brain stem abnormalities including infarction or space-occupying lesion. Endovascular coil embolization was conducted to obliterate an aneurysmal sac followed by lumbar cerebrospinal fluid (CSF) drainage. Bilateral paresis of abducens nerve completely recovered 9 weeks after ictus. In conclusion, isolated bilateral abducens nerve palsy associated with ruptured ACoA aneurysm may be resolved successfully by coil embolization and lumbar CSF drainage without directly relieving cerebrospinal fluid pressure by opening Lillequist's membrane and prepontine cistern.

• Journal of Korean Neurosurgical Society
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• v.46 no.6
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• pp.581-583
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• 2009

Abducens nerve palsy associated with spinal surgery is extremely rare. We report an extremely rare case of abducens nerve palsy after lumbar spinal fusion surgery with inadvertent dural tearing, which resolved spontaneously and completely. A 61-year-old previous healthy man presented with chronic lower back pain of 6 weeks duration and 2 weeks history of bilateral leg pain. He was diagnosed as having isthmic spondylolisthesis at L4-5 and L5-S1, and posterior lumbar interbody fusion was conducted on L4-5 and L5-S1. During the operation, inadvertent dural tearing occurred, which was repaired with a watertight dural closure. The patient recovered uneventfully from general anesthesia and his visual analogue pain scores decreased from 9 pre-op to 3 immediately after his operation. However, on day 2 he developed headache and nausea, which were severe when he was upright, but alleviated when supine. This led us to consider the possibility of cerebrospinal fluid leakage, and thus, he was restricted to bed. After an interval of bed rest, the severe headache disappeared, but four days after surgery he experienced diplopia during right gaze, which was caused by right-side palsy of the abducens nerve. Under conservative treatment, the diplopia gradually disappeared and was completely resolved at 5 weeks post-op.

• The Journal of the Society of Stroke on Korean Medicine
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• v.15 no.1
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• pp.57-65
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• 2014

■ Objectives The purpose of this case report is to show an effect of korean medicine for patient with bilateral abducens nerve palsy. ■ Methods This patient was 58 year-old man who was diagnosed with bilateral abducens nerve palsy. The patient had Diabetes Mellitus, hypertension, benign prostatic hyperplasia and dyslipidemia as underlying diseases. The patient had symptoms of limited eye movement to lateral, diplopia, dizziness and mild headache. He was treated by korean medicine, containing electroacupuncture, pharmacoacupuncture, moxibustion and herb medicines during 13 days of hospitalization and following outpatient department. His eye movement was evaluated by the method of Scott and kraft and discomfort from his symptoms was scored by the Numerous Rating Scale. And other general conditions were measured. ■ Results After that period, patient's abduction deficit was improved and subjective discomfort from his symptoms was getting better. His other conditions were also better, compared with his admission. ■ Conclusion This study suggests that Korean medicine could have a therapeutic effect for bilateral abducens nerve palsy. So, It could help to relieve patient's symptoms and make general conditions better.

• Journal of Korean Neurosurgical Society
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• v.57 no.3
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• pp.208-210
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• 2015

Tumors of the clivus and metastases to the clivus are very rare. Metastasis involving the clivus has previously been described in only two case reports. In skull metastasis, the breast and prostate are the most common primary foci, while metastasis from gastric carcinoma is extremely rare. A review of the English literature revealed only one published case of clivus metastases from gastric adenocarcinoma. There is no literature thoroughly explaining the differential diagnosis between chordoma and metastasis. Here we report a rare case of metastasis to the clivus from a gastric adenocarcinoma in a 42-year-old female patient with sudden blurry vision, presenting as bilateral cranial nerve VI palsy.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.33 no.4
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• pp.133-144
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• 2020

Objectives : The purpose of this study is to report the effect of Korean medicine treatment on limitation of eye movement in Miller-Fisher Syndrome. Methods : A patient was treated with herbal medicines, acupuncture(including electropuncture, phamacopuncture), Moxibustion and cupping therapy. To evaluate the result of this treatment, we used photographs of eye movement, Scott and Kraft score of both eye, length of eyeball movement and visual analogue scale(VAS) for subjective symptoms. Results : After treatment, the limitation of eye movement and diplopia were remarkably improved. Also, other symptoms such as dizziness, gait disturbance, facial nerve disorder were disappeared. Conclusions : This study suggests that Korean medicine treatments are effective for patient with limitation of eye movement in Miller-Fisher Syndrome.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.325-329
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• 2007

Purpose: Mobius syndrome is a rare congenital disorder characterized by facial diplegia and bilateral abducens palsy, which occasionally combines with other cranial nerve dysfunction. The inability to show happiness, sadness or anger by facial expression frequently results in social dysfunction. The classic concept of cross facial nerve grafting and free muscle transplantation, which is standard in unilateral developmental facial palsy, cannot be used in these patients without special consideration. Our experience in the treatment of three patients with this syndrome using transfer of muscles innervated by trigeminal nerve showed rewarding results. Methods: We used bilateral temporalis muscle elevated from the bony temporal fossa. Muscles and their attached fascia were folded down over the anterior surface of the zygomatic arch. The divided strips from the attached fascia were passed subcutaneously and anchored to the medial canthus and the nasolabial crease for smiling and competence of mouth and eyelids. For the recent 13 years the authors applied this method in 3 Mobius syndrome cases- 45 year-old man and 13 year-old boy, 8 year-old girl. Results: One month after the surgery the patients had good support and already showed voluntary movement at the corner of their mouth. They showed full closure of both eyelids. There was no scleral showing during eyelid closure. Also full closure of the mouth was achieved. After six months, the reconstructed movements of face were maintained. Conclusion: Temporalis muscle transfer for Mobius syndrome is an excellent method for bilateral reconstruction at one stage, is easy to perform, and has a wide range of reconstruction and reproducibility.