[Oculomotor lesions and myeloma: a case with a CT scan study (author's transl)]

A 62 year-old woman presented with a unilateral, incomplete ophthalmoplegia, and pain in the territory of the ophthalmic branch of the trigeminal nerve. She had an IgG gamma 2-lambda 2 type myeloma. Opacification by phlebography of the cavernous sinus on the affected side was not possible, neither through the ophthalmic vein nor through the anastomotic coronal veins. This suggested invasion of the sella turcica. Combined radiotherapy and chemotherapy led to rapid and almost total recovery. The lesion recurred 15 months later. Then there was a bilateral oculomotor palsy involving both external recti, and exophthalmos. CT Scan demonstrated a marked increase in size of the external recti. Special features in this case were the oculomotor paralysis and its occurrence as the initial sign of the disease, and its secondary localization in the orbits with bilateral muscle lesions.