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Loss of intrinsic and extrinsic motility of third nerve revealing breast cancer recurrence

  • Guillaume CostentinEmail author
  • Jean-Paul Bouwyn
  • Valérie Macaigne
  • Jean-Christophe Théry
  • Romain Lefaucheur
Letter to the Editor
  • 23 Downloads

Case report

A 30-year-old woman was referred for painless diplopia. Her only medical history was a breast cancer diagnosed 3 years earlier that had been treated with breast-conserving resection surgery with adjuvant chemotherapy. Breast cancer was considered in complete remission. Clinical examination only revealed mild weakness of adduction of the left eye; oculomotricity was otherwise normal. Pupils were normal. Hess–Lancaster test confirmed isolated weakness of the left medial rectus muscle. Visual acuity and fundoscopy did not reveal abnormalities. Other cranial nerves were intact. She had neither motor nor sensory weakness. Standard biological investigations, including sedimentation rate, angiotensin converting enzyme, and C-reactive protein were normal. Brain MRI only showed a discrete hypertrophy of the left medial rectus muscle. We first hypothesized that the patient had orbital myositis. Anti-nuclear, anti-neutrophil cytoplasmic, and anti-acetylcholine receptor antibodies were...

Keywords

Extrinsic and intrinsic Third nerve palsy with pupillary involvement Metastasis Oculomotor nerve 

Notes

Author contributions

GC: acquisition of data, analysis and interpretation, critical revision of the manuscript for important intellectual content, study supervision, JB: acquisition of data, analysis, and interpretation, VM: acquisition of data, analysis, and interpretation, JCT: acquisition of data, analysis, and interpretation, RL: acquisition of data, analysis and interpretation, critical revision of the manuscript for important intellectual content.

Funding

No funding was received.

Compliance with ethical standards

Conflict of interest

Guillaume Costentin declares that he has no conflict of interest. Jean-Paul Bouwyn declares that he has no conflict of interest. Valérie Macaigne declares that she has no conflict of interest. Jean Christophe Théry declares that he has no conflict of interest. Romain Lefaucheur declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Belgian Neurological Society 2018

Authors and Affiliations

  1. 1.Department of NeurologyRouen University Hospital and University of RouenRouen CedexFrance
  2. 2.Department of Medical OncologyHenri Becquerel CentreRouen CedexFrance
  3. 3.Department of RadiologyRouen University Hospital and University of RouenRouen CedexFrance

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