• Medicine · Dec 2018

    Case Reports

    Convergent strabismus fixus after bilateral abducens nerve palsies due to aneurysms: A case report.

    • Hidehiro Oku, Yuko Nishikawa, Teruyo Kida, Masahiro Tonari, Jun Sugasawa, and Tsunehiko Ikeda.
    • Medicine (Baltimore). 2018 Dec 1; 97 (51): e13766.

    RationaleConvergent strabismus fixus is an ocular motor abnormality in which the eye is fixed in adduction. This condition is mostly associated with high myopia and is caused by a displacement of the extraocular muscles. We report a nonmyopic woman with convergent strabismus fixus due to aneurysms.Patient ConcernsA 79-year-old woman complained of progressive worsening of esotropia about 50 years prior to her visit. Neuroimaging showed that the eye was not dislocated, and the extraocular muscles were not displaced. However, aneurysms were found bilaterally from the intracavernous carotid arteries and the location was on both abducens nerves.DiagnosesChronic bilateral abducens nerve palsies due to aneurysms.InterventionsEndovascular treatment was successfully performed for the aneurysms.OutcomesConvergent strabismus fixus still remained.LessonsChronic abducens nerve palsies may develop to nonmyopic convergent strabismus fixus without displacement of extraocular muscles, and mass lesions in the brain including aneurysms should be ruled out when orbital MRI cannot explain the condition.

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