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Published on: March 1, 2015
Neuro-Behçe Disease Causing Nuclear/Fascicular Forth Nerve Palsy
Eli Kisilevsky1, Edward A Margolin
1Department of Ophthalmology and Vision Sciences (EK, EAM), University of Toronto, Toronto, Canada; Department of Ophthalmology (EAM), Toronto Western Hospital, University Health Network, Toronto, Canada; and Department of Ophthalmology (EAM), Mount Sinai Hospital, Sinai Health System, Toronto, Canada.
Abstract:
Neuro-Behçe disease (NBD) has a predilection for affecting the parenchyma of the upper brainstem; however, involvement of the fourth nerve nucleus or fascicle by NBD has not been previously described. We report a case of a young man with acute right fourth nerve palsy and history of Behçet disease with an enhancing lesion in the left caudal midbrain corresponding to the left trochlear nerve nucleus/fascicle. This is the first described case of NBD producing nuclear/fascicular fourth nerve palsy. It also demonstrates an important clinicoanatomical correlate of decussation of fourth nerve fibers to the opposite side after exiting the midbrain.
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