Bilateral oculomotor nerve palsy due to chronic hypertension: A case report

Sistemik hastaliklarin seyrinde kraniyal sinir paralizilerine sikca rastlanmaktadir. Ancak hipertansiyona sekonder ucuncu kraniyal (okulomotor) sinir paralizisi oldukca na- dirdir. 72 yasinda bayan hasta iki tarafli goz kapaklarinda dusukluk sikayeti ile basvurdu. Hastanin noro-oftalmik muayenesinde, izole bilateral okulomotor sinir paralizisi mevcuttu. Kan tahlilleri ve nororadyolojik goruntulemesi normal sinirlarda idi. Lomber ponksiyonda bir ozellikle saptanmadi. Laboratuvar ve elektrofizyolojik sonuclara gore olasi myastenik bir etyoloji dislandi. Bu bulgularla hastamizda, kronik hipertansiyona sekonder iskemik kraniyal noropati gelistigi kabul edildi. Cranial nerve palsies are frequently encountered in the course of systemic diseases. However, the third cranial (oculomotor) nerve palsy secondary to hypertension is very rare. A 72-year-old woman presented with a complaint of proptosis of the eyes bilaterally. In her neuro-ophthalmic examination, isolated bilateral oculomotor nerve palsy was detected. Blood tests and neuroradiological imaging were within normal limits. A lumbar puncture was non-specific. Regarding laboratory and electrophysiological results, the possible myasthenic etiology was excluded. Together with these findings, the patient was considered to have ischemic cranial neuropathy developed secondary to chronic hyper- tension.