J Korean Med Sci.  2009 Oct;24(5):982-984. 10.3346/jkms.2009.24.5.982.

Exodeviated Ophthalmoplegia in a Patient with Progressive Supranuclear Palsy

• Kim C
• Lee HW
• Park MY

• KMID: 1782029
• DOI: http://doi.org/10.3346/jkms.2009.24.5.982

Abstract

We report a patient with progressive supranuclear palsy (PSP) with his serial photographs before the onset of ocular symptoms and after the onset with two year intervals. These photographs show his progressive eyeball deviations toward complete exotropia. There were no effective voluntary eyeball movements, Bell's phenomenon, doll's eye movements, and vestibulo-ocular reflexes. These signs indicate the involvement of the oculomotor nuclear complex by the disease. We suggest that PSP may cause not only 'supranuclear' but also 'nuclear' complete ophthalmoplegia with exodeviation of the eyes.

Keyword

Supranuclear Palsy, Progressive; Ophthalmoplegia

MeSH Terms

Aged
Exotropia/diagnosis
Eye Movements
Humans
Magnetic Resonance Imaging
Male
Ophthalmoplegia/*diagnosis
Supranuclear Palsy, Progressive/*diagnosis
Time Factors
Vision, Binocular

Figure

• 

  Fig. 1 (A) His axis of binocular vision was normal in his mid-forties. (B) At age 62, his eyes begin to exodeviate. (C) His eyes show more pronounced exodeviation at age 64. (D) His eyes are fully exodeviated at age 66. (E-G) T2-weighted midsagittal (E) and axial (G), and T1-weighted coronal MR images of the patient at age 65. Note the atrophy of the midbrain (E, G), bilateral hippocampus, and mesial frontal lobes (F).

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