Oculomotor Synkinesis (Aberrant Reinnervation of the Third Cranial Nerve) Associated with Atypical Tolosa-Hunt Syndrome

Glenn R Harris; Mark P Breazzano; Irene Shyu; Sean P Donahue; Patrick J M Lavin

doi:10.1080/01658107.2019.1576738

Oculomotor Synkinesis (Aberrant Reinnervation of the Third Cranial Nerve) Associated with Atypical Tolosa-Hunt Syndrome

Neuroophthalmology. 2019 Feb 8;44(4):262-266. doi: 10.1080/01658107.2019.1576738.

Authors

Glenn R Harris¹, Mark P Breazzano², Irene Shyu³, Sean P Donahue^{2

3

4}, Patrick J M Lavin^{2

3}

Affiliations

¹ Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
² Department of Ophthalmology & Visual Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
³ Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
⁴ Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Abstract

A 70-year-old woman with systemic lupus erythematosus developed a painful pupil-involving right third nerve palsy, ipsilateral fourth nerve palsy, and periorbital paraesthesia. Magnetic resonance imaging demonstrated enhancement and thickening of the right third nerve, and she was diagnosed with presumed Tolosa-Hunt syndrome. Repeated imaging seven months later showed resolution of the enhancing thickened oculomotor nerve, but the patient developed signs of oculomotor synkinesis. This presentation demonstrates a rare case of oculomotor synkinesis secondary to inflammation.

Keywords: Knapp transposition; Tolosa-Hunt syndrome; oculomotor synkinesis.

Publication types

Case Reports

Grants and funding

This work was supported by a grant from Tennessee Lions Charities and a grant from Research to Prevent Blindness, New York, NY.