J Korean Ophthalmol Soc.  2008 Nov;49(11):1871-1876.

Abducens Nerve Palsy Induced by Chemotherapeutic Agents

• Park JM

Abstract

PURPOSE
To report two cases of abducens nerve palsy that occurred after the administration of chemotherapeutic agents.
CASE SUMMARY
(Case 1) A 49-year-old woman with breast cancer presented with acute onset of diplopia 6 weeks after the beginning of combination chemotherapy with cyclophosphamide, doxorubicin, and paclitaxel. She had a left esotropia of 30 prism diopters (PD) with a mild decrease in abduction of the left eye. She was diagnosed with left abducens nerve palsy. (Case 2) A 29-year-old man with non-Hodgkin's lymphoma presented with diplopia 7 weeks after beginning combination chemotherapy including cyclophosphamide, adriamycin, vincristine, and prednisolone. He had a 20PD esotropia in the primary position with a slight decrease in abduction of both eyes. He was diagnosed with bilateral abducens nerve palsy. The chemotherapy regimen of both patients was changed, and they were followed up without treatment. In case 1, diplopia improved 2 months after change of chemotherapy regimen with complete recovery within 4 months. In case 2, diplopia improved 2 months after a change of chemotherapy regimen with complete recovery within 3 months.

Keyword

Abducens Nerve Palsy; Chemotherapy; Cyclophosphamide; Doxorubicin; Vincristine

MeSH Terms

Abducens Nerve
Abducens Nerve Diseases
Adult
Breast Neoplasms
Cyclophosphamide
Diplopia
Doxorubicin
Drug Therapy, Combination
Esotropia
Eye
Female
Humans
Lymphoma, Non-Hodgkin
Middle Aged
Paclitaxel
Prednisolone
Vincristine
Cyclophosphamide
Doxorubicin
Paclitaxel
Prednisolone
Vincristine

Figure

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  Figure 1. Nine cardinal photographs of case 1 patients showing mild limitation of left lateral gaze. She had a left esotropia of 30 prism diopters (PD) in the primary position.

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  Figure 2. Goldmann diplopia test in the case 1 patient (A) at the first visit. (B) After 2 months.

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  Figure 3. The Hess chart showing limited abduction in the left eye. (Case 1)

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  Figure 4. Nine cardinal photographs of case 2 patient showing mild limitation of abduction of both eyes. He had a 20PD esotropia in the primary position.

Reference

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