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Acquired "double elevator" palsy and polycythemia vera

C S Hoyt

    Journal of Pediatric Ophthalmology and Strabismus
    |November 1, 1978
    PubMed
    Summary
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    A rare case of double elevator palsy in a 67-year-old woman was linked to polycythemia vera. This blood disorder may have caused a midbrain stroke, affecting eye movements.

    Area of Science:

    • Neuro-ophthalmology
    • Hematology
    • Vascular Neurology

    Background:

    • Double elevator palsy is an uncommon condition affecting vertical eye movement.
    • Polycythemia vera is a myeloproliferative neoplasm characterized by increased red blood cell mass.

    Observation:

    • A 67-year-old woman presented with acute vertical diplopia and right hypertropia.
    • Examination confirmed a "double elevator" palsy of the left eye.
    • The patient was diagnosed with polycythemia vera.

    Findings:

    • The ocular motor disorder is attributed to a small lesion in the midbrain, affecting the right superior rectus subnucleus.
    • Increased blood viscosity from polycythemia vera is implicated as a predisposing factor for a vascular event.

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    Implications:

    • This case highlights a potential link between polycythemia vera and specific midbrain lesions causing ocular motility deficits.
    • Understanding this association may aid in diagnosing and managing similar neuro-ophthalmological presentations.