J Korean Ophthalmol Soc.  2006 Feb;47(2):332-337.

Right Superior Oblique Paralysis associated with Idopathic Hypertropic Cranial Pachymeningitis

• Kim EJ
• Kim JM
• Yoo JM

Abstract

PURPOSE: Idiopathic hypertrophic cranial pachymeningitis (IHCP) is a rare disase, which causes chronic progressive inflammation and thickening of the basal dura mater. We report a case of IHCP associated with superior oblique paralysis and present a review of the literature.
METHODS
An 8-year-old boy presented with binocular diplopia and left side head tilting. Suspecting right superior oblique muscle paralysis, an alternating prism test, head tilt test, fundus examinations, neurologic examination, and brain MRI were performed.
RESULTS
The brain MRI revealed abnormal enhancement of the right tentorium in the course of the right fourth cranial nerve, leading to a diagnosis of IHCP with paralytic strabismus and the patient was treated with systemic steroid therapy.
CONCLUSIONS
We report a case of IHCP with right superior oblique paralysis. Patients with recent onset paralytic strabismus require appropriate neurolgic and neuroimaging examinations.

Keyword

Brain MRI; Idiopathic hypertrophic cranial pachymeningitis; Superior oblique paralysis

MeSH Terms

Brain
Child
Diagnosis
Diplopia
Dura Mater
Head
Humans
Inflammation
Magnetic Resonance Imaging
Male
Meningitis*
Neuroimaging
Neurologic Examination
Paralysis*
Strabismus
Telescopes
Trochlear Nerve