RT Journal Article
SR Electronic
T1 Concomitant abducens and facial nerve palsies following blunt head trauma associated with bone fracture
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr2015210811
DO 10.1136/bcr-2015-210811
VO 2015
A1 Min-Jeong Ji
A1 Sang-Beom Han
A1 Seung-Jun Lee
A1 Moosang Kim
YR 2015
UL http://casereports.bmj.com/content/2015/bcr-2015-210811.abstract
AB A 22-year-old man was referred for horizontal diplopia that worsened on left gaze. He had been admitted for a head trauma caused by a traffic accident. Brain CT scan showed a longitudinal fracture of the left temporal bone with extension to the left carotid canal and central skull base, including sphenoid lateral wall and roof, and left orbit medial wall non-displaced fracture. Prism cover test revealed 20 prism diopters of esotropia and abduction limitation in the left eye. Hess screening test results were compatible with left abducens nerve paralysis. Symptoms suggesting complete lower motor neuron palsy of the left facial nerve, such as unilateral facial drooping, inability to raise the eyebrow and difficulty closing the eye, were present. As there was no improvement in facial paralysis, the patient received surgical intervention using a transmastoidal approach. Three months postoperatively, prism cover test showed orthotropia, however, the facial nerve palsy persisted.