Unilateral isolated oculomotor nerve palsy with antibodies to GM1 ganglioside
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Acute unilateral oculomotor nerve palsy is generally caused by either structural lesions, such as tumors, in the orbit, cavernous sinus, or subarachnoid space of the brain stem, or cerebrovascular disorders including posterior communicating artery aneurysm . Oculomotor nerve palsy is commonly associated with variant type Guillain–Barre Syndrome (GBS). Although ophthalmoplegia can occur in the absence of limb symptoms, the vast majority of ophthalmoplegia in variant type GBS affects multiple cranial nerves (multiple cranial neuropathy) and often both eyes . Here, we report a case with unilateral oculomotor nerve palsy associated with antibodies to ganglioside GM1 (anti-GM1 antibody) without other causes.
A 69-year-old woman presented to our hospital with symptoms of double vision, ptosis, and mild left orbital pain, which had developed in the past 2 days. The patient also reported symptoms of fatigue and numbness on the medial surface of both forearms, which had...
KeywordsOphthalmoplegia Multifocal Motor Neuropathy Oculomotor Nerve Palsy Painful Ophthalmoplegia Posterior Communicate Artery Aneurysm
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Supplementary material 1 (WMV 14725 kb) Video 1. This video was taken after steroid therapy (6th day after onset of ophthalmoplegia). Complete ptosis of the left eyelid is noted. Limitations are evident in the up, down, and medial gaze of the left eyeball. The movement of right eyeball is normal. The patient gave written permission for the publication of her clinical data and video