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KMID : 1038920200190020040
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Annals of Optometry and Contact Lens
2020 Volume.19 No. 2 p.40 ~ p.43
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Unilateral Oculomotor Nerve Palsy Associated with Rathke’s Cleft Cyst
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Chung Woo-Hyun
Choi Hee-Young
Jeon Hye-Shin
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Abstract
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Purpose: To report a case of unilateral oculomotor nerve palsy associated with Rathke’s cleft cyst which presented favorable prognosis after transsphenoidal surgery.
Case summary: A 64-year-old woman presented with acute-onset diplopia for two weeks. She presented 25 prism diopters (PD) exotropia, and 8 PD right hypertropia at primary position. Supraduction, infraduction and adduction was limited in the right eye and right ptosis was presented. The best-corrected visual acuity was 20/20 in both eyes. The size of bilateral pupil were symmetric and light reflex was normal. In orbital magnetic resonance image, 20 × 10 × 12 mm sized cystic lesion with high signal intensity in T2-weighted image was found at the right side of pituitary gland. The patient underwent transsphenoidal surgery for mass removal. The mass was confirmed as a Rathke’s cleft cyst in pathologic examination. At one week after surgery, ocular movement improved. The patient presented 10 PD of exotropia and diplopia was disappeared. After one month, patient was orthotropic.
Conclusions: The oculomotor nerve palsy was the only symptom of the Rathke’s cleft cyst and the patient showed excellent prognosis after transsphenoidal surgery. The Rathke’s cleft cyst should be considered in differential diagnosis of third cranial nerve palsy.
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KEYWORD
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Cranial nerve palsy, Diplopia, Oculomotor, Rathke
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