Localizing Thalamomesencephalic Afferent and Efferent Pupillary Defects

Ardalan Sharifi; Rohini R. Sigireddi; Lance J. Lyons; Ashwini T. Kini; Bayan A. Al Othman; Andrew G. Lee

doi:10.1097/WNO.0000000000000903

Localizing Thalamomesencephalic Afferent and Efferent Pupillary Defects

Ardalan Sharifi, Rohini R. Sigireddi, Lance J. Lyons, Ashwini T. Kini, Bayan A. Al Othman, Andrew G. Lee

Research output: Contribution to journal › Article › peer-review

Abstract

ABSTRACT: A 42-year-old Algerian man presented for binocular oblique diplopia, hypersomnolence with drop attacks, bilateral hearing loss, and thoracic pain. He had a right thalamomesencephalic hemorrhage due to an underlying cavernous malformation treated with subtotal surgical resection. On neuro-ophthalmic examination, the patient had a left relative afferent pupillary defect and a right oculosympathetic efferent pupillary defect (i.e., Horner syndrome) in addition to other thalamomesencephalic eye and neurologic signs (right fourth nerve palsy, hearing loss, hemiparesis, and thalamic pain). Clinicians should recognize the localizing value of this unique constellation of mesencephalic afferent and efferent pupillary defects.

Original language	English (US)
Pages (from-to)	e136-e138
Journal	Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society
Volume	41
Issue number	1
DOIs	https://doi.org/10.1097/WNO.0000000000000903
State	Published - Mar 1 2021

ASJC Scopus subject areas

Ophthalmology
Clinical Neurology

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10.1097/WNO.0000000000000903

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title = "Localizing Thalamomesencephalic Afferent and Efferent Pupillary Defects",

abstract = "ABSTRACT: A 42-year-old Algerian man presented for binocular oblique diplopia, hypersomnolence with drop attacks, bilateral hearing loss, and thoracic pain. He had a right thalamomesencephalic hemorrhage due to an underlying cavernous malformation treated with subtotal surgical resection. On neuro-ophthalmic examination, the patient had a left relative afferent pupillary defect and a right oculosympathetic efferent pupillary defect (i.e., Horner syndrome) in addition to other thalamomesencephalic eye and neurologic signs (right fourth nerve palsy, hearing loss, hemiparesis, and thalamic pain). Clinicians should recognize the localizing value of this unique constellation of mesencephalic afferent and efferent pupillary defects.",

author = "Ardalan Sharifi and Sigireddi, {Rohini R.} and Lyons, {Lance J.} and Kini, {Ashwini T.} and {Al Othman}, {Bayan A.} and Lee, {Andrew G.}",

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AU - Sharifi, Ardalan

AU - Sigireddi, Rohini R.

AU - Lyons, Lance J.

AU - Kini, Ashwini T.

AU - Al Othman, Bayan A.

AU - Lee, Andrew G.

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N2 - ABSTRACT: A 42-year-old Algerian man presented for binocular oblique diplopia, hypersomnolence with drop attacks, bilateral hearing loss, and thoracic pain. He had a right thalamomesencephalic hemorrhage due to an underlying cavernous malformation treated with subtotal surgical resection. On neuro-ophthalmic examination, the patient had a left relative afferent pupillary defect and a right oculosympathetic efferent pupillary defect (i.e., Horner syndrome) in addition to other thalamomesencephalic eye and neurologic signs (right fourth nerve palsy, hearing loss, hemiparesis, and thalamic pain). Clinicians should recognize the localizing value of this unique constellation of mesencephalic afferent and efferent pupillary defects.

AB - ABSTRACT: A 42-year-old Algerian man presented for binocular oblique diplopia, hypersomnolence with drop attacks, bilateral hearing loss, and thoracic pain. He had a right thalamomesencephalic hemorrhage due to an underlying cavernous malformation treated with subtotal surgical resection. On neuro-ophthalmic examination, the patient had a left relative afferent pupillary defect and a right oculosympathetic efferent pupillary defect (i.e., Horner syndrome) in addition to other thalamomesencephalic eye and neurologic signs (right fourth nerve palsy, hearing loss, hemiparesis, and thalamic pain). Clinicians should recognize the localizing value of this unique constellation of mesencephalic afferent and efferent pupillary defects.

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Localizing Thalamomesencephalic Afferent and Efferent Pupillary Defects

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ASJC Scopus subject areas

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