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KMID : 1036520190090010022
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Clinical Neuro-Ophthalmology
2019 Volume.9 No. 1 p.22 ~ p.25
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Abducens Nerve Palsy Due to Lymphocytic Hypophysitis
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Na Seung-Hee
Lee Eek-Sung
Maeng Lee-So
Lee Tae-Kyeong
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Abstract
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A 31-year-old woman who had been diagnosed as hypophysitis before presented with a sudden binocular horizontal diplopia with a mild headache. On neurologic examination, she only showed esotropia and abduction limitation of the left eye. Brain MRI showed diffuse enlargement of pituitary stalk and gland and the mass was extending to the internal carotid artery in the cavernous sinus. After treatment with IV methylprednisolone, her diplopia was fully regressed and pituitary mass was improved radiologically. Biopsy of the pituitary gland confirmed the lymphocytic infiltration and it was pathologically diagnosed as lymphocytic hypophysitis. Lymphocytic hypophysitis might directly compress the abducens nerve or cause inflammation of the meninges and nerve sheath. Lymphocytic hypophysitis is a rare condition but it can be considered as a differential diagnosis of sudden diplopia.
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KEYWORD
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Lymphocytic hypophysitis, Abducens nerve palsy, Diplopia
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