Abstract
Too few cases of isolated abducent nerve palsy caused by neurovascular compression syndrome have been reported. We here report on a case of abducent nerve palsy caused by neurovascular compression syndrome that was successfully treated by microvascular decompression (MVD). A 46-year-old male presented with a 6-month history of right-sided persistent abducent nerve palsy. High-resolution magnetic resonance imaging revealed a neurovascular contact of the vertebral artery with the right abducent nerve. MVD was performed via a retrosigmoid craniotomy, with remarkable improvement of the palsy. Our report suggests that MVD might be considered as an optional treatment if the symptoms progress or persist.
References
Babbitz JD, Harsh GR 4th (2005) Concomitant ectatic posterior communicating artery and tentorial meningioma as a source of oculomotor palsy: case report. Neurosurgery 57:E13–E16
Goldenberg-Cohen N, Miller NR (2004) Noninvasive neuroimaging of basilar artery dolichoectasia in a patient with an isolated abducens nerve paresis. Am J Ophthalmol 137:365–367
Hashimoto M, Ohtsuka K, Suzuki Y, Minamida Y, Houkin K (2004) Superior oblique myokymia caused by vascular compression. J Neuroophthalmol 24:237–239
Inoue T, Hirai H, Shimizu T, Tsuji M, Shima A, Suzuki F, Matsuda M (2012) Ocular neuromyotonia treated by microvascular decompression: usefulness of preoperative 3D imaging. Case report. J Neurosurg 117:1166–1169
Jannetta PJ (1981) Cranial nerve vascular compression syndromes (other than tic douloureux and hemifacial spasm). Clin Neurosurg 28:445–456
Kalkanis SN, Eskandar EN, Carter BS, Barker FG (2003) Microvascular decompression surgery in the United States, 1996 to 2000: mortality rates, morbidity rates, and the effects of hospital and surgeon volumes. Neurosurgery 52:1251–1262
Kang S, Kim JS, Hwang JM, Choi BS, Kim JH (2013) Mystery case: superior oblique myokymia due to vascular compression of the trochlear nerve. Neurology 80:e134–e135
Kato H, Nakajima M, Ohnaka Y, Ishihara K, Kawamura M (2010) Recerrent abducent nerve palsy associated with neurovascular compression. J Neurol Sci 295:135–136
King AJ, Stacey E, Stephenson G, Trimble RB (1995) Spontaneous recovery rates for unilateral sixth nerve palsies. Eye 9:476–478
Nakagawa H, Nakajima S, Nakajima Y, Furuta Y, Nishi O, Nishi K (1991) Bilateral oculomotor nerve palsies due to posterior cerebral arterial compression relieved by microvascular decompression. Neurol Med Chir (Tokyo) 31:45–48
Narai H, Manabe Y, Deguchi K, Iwatsuki K, Sakai K, Abe K (2000) Isolated abducens nerve palsy caused by vascular compression. Neurology 55:453–454
Ohtsuka K, Sone A, Igarashi Y, Akiba H, Sakata M (1996) Vascular compressive abducens nerve palsy disclosed by magnetic resonance imaging. Am J Ophthalmol 122:416–419
Ridder D, Menovsky T (2007) Neurovascular compression of the abducent nerve causing abducent palsy treated by microvascular decompression. J Neurosurg 107:1231–1234
Sandvand KA, Ringstad G, Kerty E (2008) Periodic abducens nerve palsy in adults caused by neurovascular compression. J Neurol Neurosurg Psychiatry 79:100–1002
Scharwey K, Krzizok T, Samii M, Rosahl SK, Kaufmann H (2000) Remission of superior oblique myokymia after microvascular decompression. Ophthalmologica 214:426–428
Smoker WRK, Corbett JJ, Gentry LR, Keyes WD, Price MJ, McKusker S (1986) High resolution computed tomography of the basilar artery: 2. Vertebrobasilr dolichoectasia: clinical pathologic correlation and review. AJNR Am J Neuroradiol 7:61–72
Suzuki K, Muroi A, Kujiraoka Y, Takano S, Matsumura A (2008) Oculomotor palsy treated by microvascular decompression. Surg Neurol 70:210–212
Taniguchi A, Ii Y, Kobayashi H, Maeda M, Tomimoto H (2011) Bilateral abducent nerve palsy by compression from bilateral anterior inferior cerebellar artery. J Neurol 258:2271–2273
Tsai TH, Demer JL (2011) Non-aneurysmal cranial nerve compression as cause of neuropathic strabismus: evidence from high-resolution magnetic resonance imaging. Am J Ophthalmol 152:1067–1073
Wilkins RH (1985) Neurovascular compression syndromes. Neurol Clin 3:359–372
Zhu Y, Thulborn K, Curnyn K, Goodwin J (2005) Sixth cranial nerve palsy caused by compression from a dolichoectatic vertebral artery. J Neuro-Ophthalmol 25:134–135
Acknowledgments
We would like to thank Flaminia Miyamasu, a native English speaker, for grammatical revision.
Patient consent
The patient has consented to the submission of the case report to the Journal.
Conflicts of interest
All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speaker’s bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or with any non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yamazaki, T., Yamamoto, T., Hatayama, T. et al. Abducent nerve palsy treated by microvascular decompression: a case report and review of the literature. Acta Neurochir 157, 1801–1805 (2015). https://doi.org/10.1007/s00701-015-2530-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00701-015-2530-5