Extraocular muscle cysticercosis presenting as Brown syndrome.
OBJECTIVE
Report of a case of acquired Brown syndrome caused by infestation of the superior oblique muscle by Cysticercus cellulosae.


METHODS
Case seen in a referral practice. A 20-year-old man presented with recurrent attacks of conjunctivitis and diplopia in upgaze. Clinical examination of ocular motility established a diagnosis of acquired Brown syndrome of the right eye. Computed tomography of the right orbit unequivocally established the diagnosis of superior oblique muscle cysticercosis. The patient was started on systemic steroids and albendazole in the prescribed doses for a month.


RESULTS
Serial computed tomography scans of the orbit revealed resolution of the cystic lesion after a month. Clinically, although there was restoration of ocular motility in upgaze, mild restriction of movement of the right eye in levoelevation persisted. However, the patient was symptomatically better with amelioration of the recurrent conjunctivitis and diplopia in primary gaze.


CONCLUSIONS
Extraocular muscle cysticercosis should be considered in the differential diagnosis of acquired motility disorder. The presentation of extraocular muscle cysticercosis as an acquired Brown syndrome is unusual. Response to medical therapy was satisfactory.
Pandey
P K
PK
Department of Ophthalmology, Guru Nanak Eye Centre, New Delhi, India.
Chaudhuri
Z
Z
Bhatia
A
A
D000328:Adult; D015766:Albendazole / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D003551:Cysticercosis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D015822:Eye Infections, Parasitic / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D015835:Ocular Motility Disorders / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000469:parasitology*; D009801:Oculomotor Muscles / Q000000981:diagnostic imaging / Q000187:drug effects / Q000469:parasitology*; D013577:Syndrome; D014057:Tomography, X-Ray Computed
D000981:Antiprotozoal Agents; D005938:Glucocorticoids; D015766:Albendazole