Prostate cancer metastasis to clivus causing cranial nerve VI palsy

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Prostate cancer metastasis to clivus causing cranial nerve VI palsy Kelly A. Malloy, O.D. Optometry-Journal of the American Optometric Association Volume 78, Issue 2, Pages 55-62 (February 2007) DOI: 10.1016/j.optm.2006.08.015 Copyright © 2007 American Optometric Association Terms and Conditions

Figure 1 Ocular motility testing. Note left abduction deficit. Although there appear to be evident upgaze restrictions, this was not the case. Unfortunately, a good photo in upgaze was not obtained. Optometry-Journal of the American Optometric Association 2007 78, 55-62DOI: (10.1016/j.optm.2006.08.015) Copyright © 2007 American Optometric Association Terms and Conditions

Figure 2 Results of cover testing at distance on initial presentation. Maddox Rod testing yielded similar results. Optometry-Journal of the American Optometric Association 2007 78, 55-62DOI: (10.1016/j.optm.2006.08.015) Copyright © 2007 American Optometric Association Terms and Conditions

Figure 3 Sagittal T1-weighted MRI. Arrow points to the enhancing lesion in the clivus. Optometry-Journal of the American Optometric Association 2007 78, 55-62DOI: (10.1016/j.optm.2006.08.015) Copyright © 2007 American Optometric Association Terms and Conditions

Figure 4 Axial T1-weighted postcontrast MRI. Yellow arrow points to enhancing mass in clivus. Red arrow points to second enhancing lesion in left temporal lobe. Optometry-Journal of the American Optometric Association 2007 78, 55-62DOI: (10.1016/j.optm.2006.08.015) Copyright © 2007 American Optometric Association Terms and Conditions

Figure 5 Four months postradiation treatment. Top photo, right gaze. Middle photo, left gaze. Bottom photo, left gaze viewed from the side, showing improvement (90% normal abduction). Optometry-Journal of the American Optometric Association 2007 78, 55-62DOI: (10.1016/j.optm.2006.08.015) Copyright © 2007 American Optometric Association Terms and Conditions

Figure 6 Seventeen months after initial presentation. Top, right gaze. Bottom, left gaze. Optometry-Journal of the American Optometric Association 2007 78, 55-62DOI: (10.1016/j.optm.2006.08.015) Copyright © 2007 American Optometric Association Terms and Conditions

Figure 7 Results of cover testing at distance 17 months after initial presentation (after radiation treatment). Optometry-Journal of the American Optometric Association 2007 78, 55-62DOI: (10.1016/j.optm.2006.08.015) Copyright © 2007 American Optometric Association Terms and Conditions