Acute Sixth Nerve Palsy and Retinal Hemorrhages as the Presenting Features of Acute Lymphoblastic Leukemia.

Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society
Malek A AlrobaianAmanda D Henderson

Abstract

A 36-year-old apparently healthy man presented with acute onset of diplopia. Examination demonstrated left sixth nerve palsy with 3 retinal hemorrhages noted in one eye. Gadolinium-enhanced high-resolution skull base MRI revealed left sixth nerve enhancement involving the cisternal segment. Complete blood count, cerebrospinal fluid analysis, bone marrow biopsy, and flow cytometry confirmed acute T-cell lymphoblastic leukemia with central nervous system involvement. This case demonstrates the value of high-resolution MRI in the evaluation of cranial nerve palsy in young adults and also emphasizes the importance of systemic work up in these cases, particularly when retinal findings are present.

References

Apr 1, 1994·Journal of Neurology, Neurosurgery, and Psychiatry·L Averbuch-HellerT Ben-Hur
Oct 3, 2002·Ophthalmology·George B PetersGregory B Krohel
Feb 15, 2003·Journal of Child Neurology·Kuo-Shin ChenKuang-Lin Lin
Oct 25, 2008·Irish Journal of Medical Science·E C O'NeillP T Tormey

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