Affiliations 

  • 1 Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, MYS
  • 2 Department of Ophthalmology, Universiti Sains Malaysia, Kota Bharu, MYS
  • 3 Department of Neurology, Hospital Kuala Lumpur, Kuala Lumpur, MYS
  • 4 Department of Ophthalmology, Hospital Tengku Ampuan Rahimah, Klang, MYS
Cureus, 2024 Mar;16(3):e56268.
PMID: 38623103 DOI: 10.7759/cureus.56268

Abstract

We report a case of isolated left abducens nerve palsy accompanying a right thalamic infarct. The patient, a 43-year-old Malay male with newly diagnosed hypertension, diabetes mellitus, and dyslipidemia, initially reported binocular diplopia on left lateral gaze persisting for five weeks. Subsequently, he experienced acute left-sided body weakness and slurred speech for over one day. Clinical examination revealed restricted left eye lateral gaze (-3) with no relative afferent pupillary defect. Additionally, decreased power (4/5) was noted in the left upper and lower limbs. Brain magnetic resonance imaging (MRI) revealed restricted diffusion in the right thalamus extending to the right posterior internal capsule, left anterior cingulate gyrus, and left caudate nucleus. The patient was initiated on antiplatelet, antihypertensive, and oral hypoglycemic agents, resulting in symptom improvement. This rare neuroophthalmological finding has not been reported previously.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.