J Korean Ophthalmol Soc.  2003 Aug;44(8):1919-1923.

Two Cases of Rhino-Orbitocerebral Mucormycosises that Manifested as Noninflammatory Oculomotor Nerve Palsy

• Cho KS
• Lee JY

Abstract

PURPOSE
Rhino-orbitocerebral mucormycosis is the disease that cause orbital cellulitis, orbital apex syndrome, and orbital necrosis. We report two cases of mucormycosis that began with only noninflammatory oculomotor nerve palsy. METHODS: 74-year-old man and 53-year-old woman with DM visited our hospital for sudden ptosis, mydriasis, and paralytic strabismus. MRI scan and other neurological examinations were negative except mild sinusitis. Patients were diagnosed as complete third nerve palsy. RESULTS: A few days later, they developed orbital apex syndrome with exophthalmos and abrupt reduction of visual acuity. Emergency biopsy of sinusitis was done, and revealed mucormycosis. CONCLUSIONS: Sudden oculomotor nerve palsy in chronic debilitating patients with DM and sinusitis should be suspected as prodrome of rhino-orbito-cerebral mucormycosis.

Keyword

DM; Mucormycosis; Third Nerve palsy

MeSH Terms

Aged
Biopsy
Emergencies
Exophthalmos
Female
Humans
Magnetic Resonance Imaging
Middle Aged
Mucormycosis*
Mydriasis
Necrosis
Neurologic Examination
Oculomotor Nerve Diseases*
Oculomotor Nerve*
Orbit
Orbital Cellulitis
Sinusitis
Strabismus
Visual Acuity