首页|Teaching NeuroImage: Horizontal Diplopia Due to Extraocular Muscle Metastasis
Teaching NeuroImage: Horizontal Diplopia Due to Extraocular Muscle Metastasis
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NSTL
Lippincott Williams & Wilkins
An 80-year-old woman with previously resected melanoma of the right thigh presented with acute binocular diplopia. Neurologic examination demonstrated inability to abduct the left eye with normal right eye adduction. Examination was otherwise normal. This presentation of left lateral rectus palsy can occur due to ischemic, inflammatory, autoimmune, compressive, or neoplastic etiologies. MRI orbits identified an enhancing left lateral rectus lesion consistent with extraocular muscle metastasis. MRI of the brain revealed multiple subcentimeter-enhancing lesions (Figure). Subsequent lymph node biopsy confirmed metastatic melanoma. Despite radiotherapy and BFRAF-targeted systemic therapy, rapid progression occurred, and the patient died 5 months after initial evaluation.
Merve Atik、David Nathan Abarbanel、Ugur Sener
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Department of Neurology, Mayo Clinic, Rochester, MN.
NSTL
Lippincott Williams & Wilkins
