Bilateral third nerve palsy and anterior ischemic optic neuropathy

Abstract

An elderly woman with arterial hypertension and a monoclonal gammapathy (MGUS) suffered non-simultaneous bilateral third nerve palsy and simultaneous bilateral anterior ischemic optic neuropathy, with very poor recovery. Extensive investigations and clinical course did not show evidence for a tumoral cause or temporal arteritis. In the absence of other associated disease, vascular changes related to hypertension and MGUS may have caused acute ischemia in the third nerves and optic nerves.

Key Words:

• third nerve palsy
• ischemic optic neuropathy
• monoclonal gammapathy