Isolated inferior rectus paresis secondary to a mesencephalic cavernous angioma.
OBJECTIVE
To report a case of recurrent binocular, vertical diplopia presenting as an isolated, unilateral inferior rectus paresis occurring in a patient with a mesencephalic tegmental cavernous angioma.


METHODS
Case report. A 30-year-old man with recurrent vertical diplopia underwent neuro-ophthalmic examination, laboratory examination, pharmacologic testing, and magnetic resonance imaging and angiography.


RESULTS
Magnetic resonance imaging disclosed a lesion in the mesencephalon consistent with a cavernous angioma. Magnetic resonance angiography was negative.


CONCLUSIONS
Isolated inferior rectus paresis is a rare phenomenon. This unique case involved a patient with recurrent inferior rectus paresis secondary to a mesencephalic cavernous angioma. The disparity between the extent of the lesion and the neuro-ophthalmologic consequences is remarkable.
Harrison
A R
AR
Department of Ophthalmology, University of Minnesota, Minneapolis 55455-0501, USA.
Wirtschafter
J D
JD
D000328:Adult; D001932:Brain Neoplasms / Q000150:complications* / Q000175:diagnosis; D004172:Diplopia / Q000175:diagnosis / Q000209:etiology; D006392:Hemangioma, Cavernous / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000209:etiology*; D012008:Recurrence; D013681:Tegmentum Mesencephali / Q000473:pathology*; D015348:Vision, Binocular; D014792:Visual Acuity