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Transient Recurring Paralysis of Ocular Abduction: A Syndrome of Intracranial Hypertension

Transient Recurring Paralysis of Ocular Abduction: A Syndrome of Intracranial Hypertension Abstract Paralysis of the abducens nerve may be a consequence of intracranial hypertension of whatever cause. The vulnerability of this nerve has been ascribed to stretching and bony impingement with downward displacement of the brain stem,1,2 to notching by branches of the basilar artery,3 and, in a general way, to its long unprotected course. The loss of ocular abduction, which is equated with paralysis of the nerve, while subject to some variation, is usually persistent over a period of days or weeks. The opportunity to observe transient and recurring paralysis of ocular abduction in two patients suffering from intracranial hypertension has prompted this description of a phenomenon which has received limited attention in the past.3-7 The fluctuating level of function in this condition might be explained by proposing short-lived changes in the dynamics of abducens paralysis noted above. However, the associated symptoms in one of the patients References 1. "In einem Falle von Zystenbildung im Vermis cerebelli sah ich beim Aufrichten der Patientin eine abduzenslähmung eitreten, die im Liegen wieder schwand." 2. Collier, J.: The False Localising Signs of Intracranial Tumour , Brain 27:490-508, 1904.Crossref 3. Sunderland, S.: Neurovascular Relations and Anomalies at the Base of the Brain , J Neurol Neurosurg Psychiat 11:243-257, 1948.Crossref 4. Cushing, H.: Strangulation of the Nervi Abducentes by Lateral Branches of the Basilar Artery in Cases of Brain Tumor , Brain 33:204-235, 1910.Crossref 5. Lundberg, N.: " Continuous Recording and Control of Ventricular Fluid Pressure in Neurosurgical Practice ," in Krabbe, K. H. (ed.): Acta Psychiatrica et Neurologica Scandinavia , Copenhagen: Ejnar Munksgaard, vol 36, 1960. 6. Van Allen, M.W.: " Transient Recurring Paralysis of Ocular Abduction ," in Yahr, M. (ed.): Transactions of the American Neurological Association , New York: Springer Publishing Co., 1965, vol 90, pp 303-304. 7. Oppenheim, H.: Lehrbuch des Nervenkrankheiten , ed 7, Berlin: Karger, 1923, vol 2, 1422. 8. Malek, J.C., and Green, D.: Episodic Abducens Paralysis During Transient Decerebrate Rigidity Associated With a Colloid Cyst of the Third Ventricle , Neurology 13:538-540, 1963.Crossref 9. Joynt, R.J., and Perret, G.E.: Meningiomas in a Mother and Daughter , Neurology 11:164-165. 1961.Crossref 10. Langfitt, T.W.; Weinstein, J.D.; and Kassell. N.F.: Cerebral Vasomotor Paralysis Produced by Intracranial Hypertension , Neurology 15:622-641, 1965.Crossref 11. Langfitt, T.W.; Kassell, N.F.; and Weinstein, J.D.: Cerebral Blood Flow With Intracranial Hypertension , Neurology 15:761-773, 1965.Crossref 12. Allerand, C.D.: Paroxysmal Skew Deviation in Association With a Brain Stem Glioma , Neurology 12:520-523, 1962.Crossref 13. Norris, F.H., and Fawcett, J.: A Sign of Intracranial Mass With Impending Uncal Herniation , Arch Neurol 12:381-386, 1965.Crossref 14. McNealy, D.E., and Plum, F.: Brainstem Dysfunction With Supratentorial Mass Lesions , Arch Neurol 7:10-32, 1962.Crossref 15. Chamlin, M., and Davidoff, L.M.: Divergence Paralysis With Increased Intracranial Pressure , J Neurosurg 7:539-543, 1950.Crossref 16. Lindenberg, R.: Compression of Brain Arteries as Pathogenetic Factor for Tissue Necroses and Their Areas of Predilection , J Neuropath Exp Neurol 14:223-243, 1955.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Transient Recurring Paralysis of Ocular Abduction: A Syndrome of Intracranial Hypertension

Van Allen, Maurice W.
Archives of Neurology , Volume 17 (1) – Jul 1, 1967
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References (21)

Publisher
American Medical Association
Copyright
Copyright © 1967 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1967.00470250085009
Publisher site
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Abstract

Abstract Paralysis of the abducens nerve may be a consequence of intracranial hypertension of whatever cause. The vulnerability of this nerve has been ascribed to stretching and bony impingement with downward displacement of the brain stem,1,2 to notching by branches of the basilar artery,3 and, in a general way, to its long unprotected course. The loss of ocular abduction, which is equated with paralysis of the nerve, while subject to some variation, is usually persistent over a period of days or weeks. The opportunity to observe transient and recurring paralysis of ocular abduction in two patients suffering from intracranial hypertension has prompted this description of a phenomenon which has received limited attention in the past.3-7 The fluctuating level of function in this condition might be explained by proposing short-lived changes in the dynamics of abducens paralysis noted above. However, the associated symptoms in one of the patients References 1. "In einem Falle von Zystenbildung im Vermis cerebelli sah ich beim Aufrichten der Patientin eine abduzenslähmung eitreten, die im Liegen wieder schwand." 2. Collier, J.: The False Localising Signs of Intracranial Tumour , Brain 27:490-508, 1904.Crossref 3. Sunderland, S.: Neurovascular Relations and Anomalies at the Base of the Brain , J Neurol Neurosurg Psychiat 11:243-257, 1948.Crossref 4. Cushing, H.: Strangulation of the Nervi Abducentes by Lateral Branches of the Basilar Artery in Cases of Brain Tumor , Brain 33:204-235, 1910.Crossref 5. Lundberg, N.: " Continuous Recording and Control of Ventricular Fluid Pressure in Neurosurgical Practice ," in Krabbe, K. H. (ed.): Acta Psychiatrica et Neurologica Scandinavia , Copenhagen: Ejnar Munksgaard, vol 36, 1960. 6. Van Allen, M.W.: " Transient Recurring Paralysis of Ocular Abduction ," in Yahr, M. (ed.): Transactions of the American Neurological Association , New York: Springer Publishing Co., 1965, vol 90, pp 303-304. 7. Oppenheim, H.: Lehrbuch des Nervenkrankheiten , ed 7, Berlin: Karger, 1923, vol 2, 1422. 8. Malek, J.C., and Green, D.: Episodic Abducens Paralysis During Transient Decerebrate Rigidity Associated With a Colloid Cyst of the Third Ventricle , Neurology 13:538-540, 1963.Crossref 9. Joynt, R.J., and Perret, G.E.: Meningiomas in a Mother and Daughter , Neurology 11:164-165. 1961.Crossref 10. Langfitt, T.W.; Weinstein, J.D.; and Kassell. N.F.: Cerebral Vasomotor Paralysis Produced by Intracranial Hypertension , Neurology 15:622-641, 1965.Crossref 11. Langfitt, T.W.; Kassell, N.F.; and Weinstein, J.D.: Cerebral Blood Flow With Intracranial Hypertension , Neurology 15:761-773, 1965.Crossref 12. Allerand, C.D.: Paroxysmal Skew Deviation in Association With a Brain Stem Glioma , Neurology 12:520-523, 1962.Crossref 13. Norris, F.H., and Fawcett, J.: A Sign of Intracranial Mass With Impending Uncal Herniation , Arch Neurol 12:381-386, 1965.Crossref 14. McNealy, D.E., and Plum, F.: Brainstem Dysfunction With Supratentorial Mass Lesions , Arch Neurol 7:10-32, 1962.Crossref 15. Chamlin, M., and Davidoff, L.M.: Divergence Paralysis With Increased Intracranial Pressure , J Neurosurg 7:539-543, 1950.Crossref 16. Lindenberg, R.: Compression of Brain Arteries as Pathogenetic Factor for Tissue Necroses and Their Areas of Predilection , J Neuropath Exp Neurol 14:223-243, 1955.Crossref

Journal

Archives of Neurology – American Medical Association

Published: Jul 1, 1967

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