Korean J Ophthalmol.  2012 Feb;26(1):65-68. 10.3341/kjo.2012.26.1.65.

Abducens Nerve Palsy Complicated by Inferior Petrosal Sinus Septic Thrombosis Due to Mastoiditis

• Jang JH
• Park JM
• Kwon J
• Lee SJ

• KMID: 1120186
• DOI: http://doi.org/10.3341/kjo.2012.26.1.65

Abstract

We present a very rare case of a 29-month-old boy with acute onset right abducens nerve palsy complicated by inferior petrosal sinus septic thrombosis due to mastoiditis without petrous apicitis. Four months after mastoidectomy, the patient fully recovered from an esotropia of 30 prism diopters and an abduction limitation (-4) in his right eye.

Keyword

Abducens nerve diseases; Inferior petrosal sinus thrombosis; Mastoiditis; Otitis media

MeSH Terms

Abducens Nerve Diseases/diagnosis/*etiology
Child, Preschool
Diagnosis, Differential
Humans
Male
Mastoiditis/*complications/diagnosis/surgery
Otitis Media/*complications/diagnosis
Sinus Thrombosis, Intracranial/*complications/diagnosis

Figure

• 

  Fig. 1 Photographs show an anomalous head posture of right-turning facial position, an abduction defect (-4), and an esodeviation of 30 prism diopters in his right eye. Informed consent was received from parents of the patient.

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  Fig. 2 (A) Preoperative axial enhanced T2-weighted magnetic resonance (MR) image shows right otomastoiditis. (B) Preoperative coronal enhanced T2-weighted MR image shows right otomastoiditis. (C) Axial enhanced T1-weighted MR image shows slow flow velocity of the right transverse sinus (white arrow). (D) Coronal enhanced T1-weighted MR image shows slow-flow velocity of the right internal jugular vein (black arrow).

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  Fig. 3 Computed tomography of the right temporal bone shows no inflammation of the petrous bone (white arrow) and an erosive mastoid septa (black arrow).

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  Fig. 4 Photographs show orthotropia and no limitation of abduction in the right eye at 4 months after mastoidectomy.

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