Acute Isolated Abducens Paresis as an Initial Presentation of Metastatic Small Cell Lung Cancer

Abstract

A 57-year-old healthy male bus driver presented himself with a complaint of acute diplopia that lasted a few hours. Ophthalmologic examination disclosed a visual acuity of 6/7.5 in the right eye and 6/6 in the left eye. Isolated right abducens palsy was the only abnormal finding. However, brain MRI showed multiple brain metastatic lesions and bronchial biopsy revealed small cell lung cancer as the primary malignancy. The patient then received a series of chemotherapy treatments and brain radiotherapy. Six months later, this patient died of multiple organ failure despite aggressive treatment.

Keywords:

• ophthalmoplegia
• small cell lung cancer
• abducens nerve palsy