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Positive tensilon test and intracranial tumor: a case report
1Department of Ophthalmology, O Floor, Royal Hallamshire Hospital, Sheffield, UK. mohiteye@yahoo.co.uk
European Journal of Ophthalmology
|September 2, 2003
Summary
A positive Tensilon test, typically indicating myasthenia gravis, can also be associated with intracranial tumors. This case highlights the importance of considering neurological tumors in differential diagnoses, even with classic myasthenia gravis signs.
Area of Science:
- Neurology
- Neurosurgery
- Ophthalmology
Background:
- The Tensilon test is a diagnostic tool commonly used to diagnose myasthenia gravis, a neuromuscular disorder.
- Sixth nerve palsy can be caused by various neurological conditions, including myasthenia gravis and intracranial tumors.
Observation:
- A 19-year-old male presented with left sixth nerve palsy and a highly positive Tensilon test, initially diagnosed as myasthenia gravis.
- Neurological imaging revealed an intracranial tumor, specifically a schwannoma, located in the left temporal fossa.
Findings:
- Surgical removal of the schwannoma was performed.
- Despite tumor removal, the patient's sixth nerve palsy did not improve two years post-surgery.
Implications:
- This case underscores that a positive Tensilon test does not exclude the possibility of an associated intracranial tumor.
- It emphasizes the need for comprehensive diagnostic evaluation, including neuroimaging, in patients presenting with neurological deficits and positive diagnostic tests.
- The persistent VIth nerve palsy suggests potential long-term neurological sequelae or alternative underlying causes.
