[VIth nerve palsy associated with ipsilateral Horner's pupil]

A rare syndrome which includes VIth nerve palsy associated with ipsilateral Horner's pupil was foreseen by Parkinson and Johnston in the mid-seventies. They anticipated the occurrence of this syndrome on the basis of the unique anatomical relationships discovered by them in the cavernous sinus. The main finding consisted of very close proximity between the VIth nerve and a branch emerging from the carotid sympathetic plexus. Recently, several reports of this syndrome caused by a variety of pathologic processes in the cavernous sinus, proved that Parkinson and Johnston were correct. Since it is quite difficult to identify lesions in the cavernous sinus by X-ray or CT scan, the neuroradiologist should utilize special techniques. It is expected that the number of cases of this syndrome will soon increase, due to increasing familiarity with the syndrome and to improved imaging techniques.