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Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 35-year-old woman with headache and diplopia.

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Presentation on theme: "Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 35-year-old woman with headache and diplopia."— Presentation transcript:

1 Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 35-year-old woman with headache and diplopia

2 35-year-old woman with new onset occipital headache not responding to paracetamol for a week Blurred vision for two days Neurological exam revealed horizontal diplopia at left gaze with limited abduction of left eye Normal vital signs, no meningism, remainder of exam normal Vignette Safouris et al.

3 A CB Imaging A

4 Isolated sphenoiditis represents <3% of sinusitis Rarely complicated by abducens palsy due to nerve’s proximity to sphenoid sinus at level of petrous apex and cavernous sinus If untreated, may be complicated by septic cavernous sinusitis or meningitis First line treatment is antibiotics and corticosteroids If symptoms persist despite medical therapy, consider endoscopy for bacteriological diagnosis and evacuation Safouris et al. Isolated sphenoiditis: An uncommon cause of abducens palsy

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