Fourth down and five

Surv Ophthalmol. 2019 Sep-Oct;64(5):734-740. doi: 10.1016/j.survophthal.2018.06.005. Epub 2018 Jun 28.

Abstract

Binocular diplopia and right hemifacial numbness developed in a 52-year-old woman after resection of a right temporal lobe glioblastoma. Based on the Parks-Bielschowsky 3-step test, she was diagnosed with a right cranial nerve (CN) IV palsy in addition to right CN V dysfunction. Iatrogenic diplopia may result from temporal lobe surgery due to the intimate relationship of CN IV and CN III to the mesial temporal lobe. In addition, injury to CN V within Meckel cave is believed to be the cause of facial numbness in some patients after temporal lobe surgery. The anatomy of the intracranial portion of CN IV is reviewed, and the etiologies of CN IV palsy are discussed.

Keywords: cranial nerve palsy; diplopia; facial numbness; fourth cranial nerve; temporal lobe.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain Ischemia / complications*
  • Brain Ischemia / diagnosis
  • Cranial Nerve Diseases / complications*
  • Cranial Nerve Diseases / diagnosis
  • Diagnosis, Differential
  • Diplopia / diagnosis
  • Diplopia / etiology*
  • Diplopia / physiopathology
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Temporal Lobe / diagnostic imaging
  • Visual Fields / physiology*