Sixth Nerve Palsy and Unilateral Horner's Syndrome

Gutman, Isaac; Levartovski, S.; Goldhammer, Y.; Tadmor, Rina; Findler, Gideon

doi:10.1016/s0161-6420(86)33642-x

Cited by 33 publications

(19 citation statements)

References 8 publications

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“…10,11) Abducens nerve paresis and Horner's syndrome can be caused by intracavernous aneurysm and petrous apex tumors, but the sweating function, which is another component of Horner's syndrome, was not mentioned. 5,13) However, involvement of the periarterial sympathetic plexus in the dissection of ICA present as incomplete Horner's syndrome, which is characterized with ptosis and myosis but not anhydrosis, due to sparing of the external carotid plexus, which innervates the facial sweat glands. 1) Similarly, the absence of anhydrosis in our case indicates incomplete Horner's syndrome.…”

Section: Discussionmentioning

confidence: 99%

Isolated Abducens Nerve Paresis Associated With Incomplete Horner's Syndrome Caused by Petrous Apex Fracture. Case Report and Anatomical Study.

Uchida

et al. 2001

Neurol. Med. Chir.(Tokyo)

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A 17-year-old male presented with a wound on the right temporal region, oozing hemorrhagic necrotic brain tissue and cerebrospinal fluid, following a fall. Computed tomography showed temporoparietal and petrous apex fractures on the right. Neurological examination revealed abducens nerve paresis, ptosis, and myosis on the right side. The patient was treated surgically for the removal of the free bony fragments at the fracture site and to close the dural tear. The abducens nerve paresis, ptosis, and myosis persisted at the 3rd monthly postoperative follow-up examination. The anatomy of the abducens nerve at the petroclival region was studied in four cadaveric heads. Two silicone-injected heads were used for microsurgical dissections and two for histological sections. The abducens nerve has three different angulations in the petroclival region, located at the dural entrance porus, the petrous apex, and the lateral wall of the cavernous segment of the internal carotid artery. The abducens nerve had fine anastomoses with the trigeminal nerve and the periarterial sympathetic plexus. There were fibrous connections extending inside the venous space of the petroclival area. The abducens nerve seems to be vulnerable to damage in the petroclival region, either directly by trauma to its dural porus and petrous apex or indirectly by stretching of the nerve through the nervous and/or fibrous connections. Concurrent functional loss of the abducens nerve and the periarterial sympathetic plexus clinically manifested as incomplete Horner's syndrome in our patient.

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Section: Discussionmentioning

confidence: 99%

Isolated Abducens Nerve Paresis Associated With Incomplete Horner's Syndrome Caused by Petrous Apex Fracture. Case Report and Anatomical Study.

Uchida

et al. 2001

Neurol. Med. Chir.(Tokyo)

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“…Neuroimaging demonstrated erosion of the petrous bone and a massive lesion in the cavernous sinus (5). In the latter 2 reports, the clinical courses were not noted (5,13). In the present patient, the combination of abducens nerve palsy and ipsilateral Horner syndrome appeared as a sign of relapsing parotid carcinoma.…”

Section: Discussionmentioning

confidence: 97%

“…In 1979, Parkinson (15) predicted that lesions within the cavernous sinus could simultaneously induce abducens nerve palsy and ipsilateral Horner syndrome based on these anatomical findings. Only 17 patients with a combination of abducens nerve palsy and ipsilateral Horner syndrome have been reported in the English language literature (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). These cases included an intracavernous internal carotid artery (ICA) aneurysm (1-7), occlusion of the ICA (8), cavernous sinus thrombosis (9), trauma (10, 11) and neoplasm (5,6,(12)(13)(14).…”

Section: Discussionmentioning

confidence: 99%

“…The combination of abducens nerve palsy and ipsilateral Horner syndrome has rarely been reported (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). It is considered that the lesion is located in the posterior portion of the cavernous sinus, where sympathetic nerve fibers join the abducens nerve for a short distance (15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

“…It is considered that the lesion is located in the posterior portion of the cavernous sinus, where sympathetic nerve fibers join the abducens nerve for a short distance (15)(16)(17)(18). Only 2 patients with gastric carcinoma and breast carcinoma, who developed these symptoms due to metastatic carcinoma in the cavernous sinus have been reported (5,13). In this paper, we report the first case showing a combination of abducens nerve palsy and ipsilateral Horner syndrome secondary to metastasis of primary parotid carcinoma to the cavernous sinus.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Abducens Nerve Palsy and Homer Syndrome Due to Metastatic Tumor in the Cavernous Sinus

et al. 2005

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A 41-year-old man was diagnosed as having primary parotid carcinoma on the right side. After radical parotidectomy, radiation therapy and systemic chemotherapy, the primary parotid carcinoma was completely remitted. Two years later, right abducens nerve palsy and Horner syndrome appeared. Neuroimaging demonstrated a gadolinium-enhanced lesion in the posterior portion of the right cavernous sinus, and metastasis of parotid carcinoma was suspected. After radiosurgery and systemic chemotherapy, the intracavernous lesion disappeared. This is the first case of combination of abducens nerve palsy and ipsilateral Horner syndrome due to metastasis from parotid carcinoma to the cavernous sinus.

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One-and-a-half Syndrome, Type II

Carter

Rauch

1994

Archives of Neurology

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Sixth Nerve Palsy and Unilateral Horner's Syndrome

Cited by 33 publications

References 8 publications

Isolated Abducens Nerve Paresis Associated With Incomplete Horner's Syndrome Caused by Petrous Apex Fracture. Case Report and Anatomical Study.

Isolated Abducens Nerve Paresis Associated With Incomplete Horner's Syndrome Caused by Petrous Apex Fracture. Case Report and Anatomical Study.

Abducens Nerve Palsy and Homer Syndrome Due to Metastatic Tumor in the Cavernous Sinus

One-and-a-half Syndrome, Type II

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