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Transient unilateral ophthalmoplegia without papilledema in a child with intracranial hypertension

Yusuf Izci1, Alpaslan Kırık, Fatih Mehmet Mutlu

  • 1Department of Neurosurgery, Gulhane Military Medical Academy, Ankara, Turkey.

Saudi Journal of Ophthalmology : Official Journal of the Saudi Ophthalmological Society
|August 21, 2013
PubMed

Insights

Intracranial hypertension can cause complete ophthalmoplegia in children, even without papilledema. Prompt diagnosis and treatment, like shunt insertion, can resolve this rare condition and save lives.

Area of Science:

  • Pediatric Neurology
  • Ophthalmology
  • Neurosurgery

Background:

  • Intracranial hypertension typically presents with papilledema and headache.
  • Complete ophthalmoplegia is an exceptionally rare sign of increased intracranial pressure in pediatric cases.
  • This case highlights a deviation from typical presentations.

Purpose of the Study:

  • To report a rare case of pediatric intracranial hypertension presenting with ophthalmoplegia without papilledema.
  • To emphasize the importance of considering unusual symptoms in diagnosing intracranial hypertension.
  • To illustrate the successful management and resolution of this condition.

Main Methods:

  • Case report of a 5-year-old male with unilateral ophthalmoplegia.
  • Diagnostic workup included fundoscopic examination and brain MRI, which were normal.
  • Treatment involved lumboperitoneal shunt insertion for intracranial hypertension.

Main Results:

  • The patient presented with unilateral ophthalmoplegia attributed to increased intracranial pressure.
  • Despite normal initial findings (fundoscopy, MRI), intracranial hypertension was confirmed.
  • Following lumboperitoneal shunt insertion, ophthalmoplegia resolved within one month.

Conclusions:

  • Complete ophthalmoplegia without papilledema can be a manifestation of intracranial hypertension in children.
  • Early and precise diagnosis is crucial for effective management.
  • Timely intervention to reduce intracranial pressure is vital for patient survival and recovery.

Keywords:
Intracranial hypertensionOphthalmoplegiaPapilledema

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