Transient alternating ophthalmoplegia in sphenoid sinus mucocele

Abstract

The authors observed a 32-year-old patient who successively developed a left sixth and a pupil sparing right third nerve palsy due to a large inflamed sphenoid sinus mucocele. The ocular motor deficits resolved spontaneously within two weeks, and did not recur after surgical drainage of the lesion. Sphenoid sinus mucoceles rarely present with transient and recurrent ophthalmoplegias but must be considered in the differential diagnosis of this presentation. Possible mechanisms of ocular motor nerve dysfunction include inflammatory involvement, compression and microvascular ischemia due to lateral extension of the mucocele into the cavernous sinus.

Key Words:

• Sphenoid sinus
• mucocele
• ophthalmoplegia