Two cases of fourth nerve palsy in pregnancy
Aim: To present two cases of recent-onset fourth nerve palsies during pregnancy. Methods: Two pregnant patients presented to A&E with recent-onset diplopia due to isolated right superior oblique palsy. Patient 1, aged 42, complained of a 5-day history of intermittent vertical diplopia at 38 week...
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doaj-dfd59298a7824cd0ac126f3bff6c311d2020-11-24T21:55:31ZengWhite Rose University PressBritish and Irish Orthoptic Journal2516-35902016-08-0113485110.22599/bioj.103102Two cases of fourth nerve palsy in pregnancyAmrit Sehmi0Jamil Hakim1G.G.W. Adams2Orthoptic Department, Moorfields Eye Hospital NHS Foundation Trust, LondonOphthalmology Department, Kings College London NHS Foundation Trust, LondonOphthalmology Department, Moorfields Eye Hospital NHS Foundation Trust, LondonAim: To present two cases of recent-onset fourth nerve palsies during pregnancy. Methods: Two pregnant patients presented to A&E with recent-onset diplopia due to isolated right superior oblique palsy. Patient 1, aged 42, complained of a 5-day history of intermittent vertical diplopia at 38 weeks gestation. Patient 2, aged 34, presented with constant horizontal and vertical diplopia at 34 weeks gestation. Results: Two months after giving birth, patient 1 attended the eye clinic reporting her symptoms had completely resolved within 5 days from onset. Patient 2 reported her symptoms resolved within 3 months. Both patients fully recovered, therefore no further management or investigation was required. They both gave birth at term without complication. Patient 1 presented with a slight hyperphoria in primary position, demonstrating binocular single vision (BSV). Ocular motility and Hess chart showed a very slight right superior oblique under-action. Her blood pressure, fundus and media were normal and no underlying pathology was found. No further investigations were undertaken. Patient 2 presented with a slight exotropia and right hypertropia in primary position, with diplopia and no BSV demonstrable. Further orthoptic testing showed right superior oblique under-action. No pathology was found. Conclusions: Cranial nerve palsies developing in pregnancy are rare but have been reported. No pathology was found in our cases; however, the literature does suggest that serious cases could be apparent and should therefore be considered.https://www.bioj-online.com/articles/103Cranial nervesPregnancy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Amrit Sehmi Jamil Hakim G.G.W. Adams |
spellingShingle |
Amrit Sehmi Jamil Hakim G.G.W. Adams Two cases of fourth nerve palsy in pregnancy British and Irish Orthoptic Journal Cranial nerves Pregnancy |
author_facet |
Amrit Sehmi Jamil Hakim G.G.W. Adams |
author_sort |
Amrit Sehmi |
title |
Two cases of fourth nerve palsy in pregnancy |
title_short |
Two cases of fourth nerve palsy in pregnancy |
title_full |
Two cases of fourth nerve palsy in pregnancy |
title_fullStr |
Two cases of fourth nerve palsy in pregnancy |
title_full_unstemmed |
Two cases of fourth nerve palsy in pregnancy |
title_sort |
two cases of fourth nerve palsy in pregnancy |
publisher |
White Rose University Press |
series |
British and Irish Orthoptic Journal |
issn |
2516-3590 |
publishDate |
2016-08-01 |
description |
Aim: To present two cases of recent-onset fourth nerve palsies during pregnancy. Methods: Two pregnant patients presented to A&E with recent-onset diplopia due to isolated right superior oblique palsy. Patient 1, aged 42, complained of a 5-day history of intermittent vertical diplopia at 38 weeks gestation. Patient 2, aged 34, presented with constant horizontal and vertical diplopia at 34 weeks gestation. Results: Two months after giving birth, patient 1 attended the eye clinic reporting her symptoms had completely resolved within 5 days from onset. Patient 2 reported her symptoms resolved within 3 months. Both patients fully recovered, therefore no further management or investigation was required. They both gave birth at term without complication. Patient 1 presented with a slight hyperphoria in primary position, demonstrating binocular single vision (BSV). Ocular motility and Hess chart showed a very slight right superior oblique under-action. Her blood pressure, fundus and media were normal and no underlying pathology was found. No further investigations were undertaken. Patient 2 presented with a slight exotropia and right hypertropia in primary position, with diplopia and no BSV demonstrable. Further orthoptic testing showed right superior oblique under-action. No pathology was found. Conclusions: Cranial nerve palsies developing in pregnancy are rare but have been reported. No pathology was found in our cases; however, the literature does suggest that serious cases could be apparent and should therefore be considered. |
topic |
Cranial nerves Pregnancy |
url |
https://www.bioj-online.com/articles/103 |
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AT amritsehmi twocasesoffourthnervepalsyinpregnancy AT jamilhakim twocasesoffourthnervepalsyinpregnancy AT ggwadams twocasesoffourthnervepalsyinpregnancy |
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