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Oculomotor palsy with cyclic spasms: a case report.
Bülent Yazici1, Mehmet Unal, Murat Köksal
1Department of Ophthalmology, Uludag University, Bursa, Turkey
Orbit (Amsterdam, Netherlands)
|June 5, 2002
Summary
This study details a rare case of oculomotor palsy with cyclic spasms in an 18-year-old male, characterized by alternating eyelid and pupil movements. The condition, unresponsive to baclofen, highlights the complexities of third cranial nerve disorders.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Oculomotor palsy with cyclic spasms is a rare, non-progressive disorder affecting third cranial nerve-innervated muscles.
- Characterized by alternating rhythmic spasm and paralysis of these muscles.
Purpose of the Study:
- To describe a unique case of oculomotor palsy with cyclic spasms in an 18-year-old male.
- To document the clinical presentation, diagnostic findings, and therapeutic trial outcomes.
Main Methods:
- Clinical examination of an 18-year-old male with congenital left upper eyelid ptosis.
- Observation of cyclic eyelid and pupil movements (ptosis/mydriasis alternating with retraction/miosis).
- Assessment of pupil diameter, interpalpebral fissure changes, and voluntary muscle control.
Main Results:
- The patient exhibited cyclic movements of the left eyelid and pupil, with significant variations in interpalpebral fissure (2-11 mm) and pupil diameter (3-6 mm).
- No voluntary control over the affected eye's muscles was noted; the eye was amblyopic and exotropic.
- Systemic evaluation and cranial MRI were normal. A trial of oral baclofen (30 mg/day) was ineffective.
Conclusions:
- The case presents a distinct manifestation of oculomotor palsy with cyclic spasms.
- The ineffectiveness of baclofen suggests limited pharmacological options for this specific presentation.