Sixth nerve palsy+ipsilateral Horner’s Syndrome=Parkinson’s Syndrome

Abstract

Lesions on the cavernous sinus need to be considered in cases of abducens nerve palsy and ipsilateral Horner's Syndrome.

Nasopharyngeal carcinoma presenting as a sixth nerve palsy and Horner’s syndrome

“…This patient also had involvement of V2 due to perineural spread of the tumour in the cavernous sinus. The largest case series on the topic of combined sixth nerve palsy and Horner’s syndrome was by Ebner et al 4 who included five cases due to cavernous sinus meningiomas (n=2), carotid-cavernous anuerysm, metallic foreign body and squamous cell carcinoma. Additional case reports have documented additional causes such as a cavernous-carotid aneurysms,5 6 petrous interal carotid artery aneurysm,7 carotid cavernous-sinus fistula,8 9 facial abscess,10 herpes zoster ophthalmicus arteritis11 and metastatic carcinomas 12 13.…”

Abducens nerve palsy and ipsilateral Horner syndrome as the presenting finding of carotid cavernous fistula

“…3,7 Recently, StopLoss Jones tubes (FCI Ophthalmic, Pembroke, MA) have been reported to have less extrusion rates, because of a silicone flange encircling the tube's medial end. 8,9 Biological materials have been used for tear drainage in the past. Morax and Vialeix 10 first described using a skin graft to wrap a piece of paraffin wax placed into a newly created nasolacrimal passage.…”

“…Parkinson sign has been reported with numerous different etiologies, including intracavernous carotid aneurysms, 4À6 metastatic tumours, 5,7,8 meningiomas, 9 and posttrauma CCFs. 10,11 To our knowledge however, this is the first case of Parkinson sign as the presenting finding of a type D CCF in the English language ophthalmic literature.…”

True and False Localization in Neuro-ophthalmology—A Report of Two Cases

“…The Parkinson sign is classically described as a sixth nerve palsy and an ipsilateral Horner syndrome that localizes to the cavernous sinus. 1,2 The localizing value of any afferent and efferent (e.g., Horner syndrome) pupillary finding with an ipsilateral ocular motor cranial neuropathy merits revisiting the Parkinson sign. 3,4 For example, a unilateral pupil-sparing cranial nerve III palsy with an ipsilateral smaller pupil (rather than a larger pupil), a normal pupillary light reaction, an anisocoria worse in the dark (ocular sympathetic pupil dilation problem), and absence of aberrant regeneration suggests a concurrent ipsilateral Horner syndrome.…”