DR. R NIYANTHRI

Dr.Madhumita Gopal, Dr. NIRMALA DEVY KRISHNAN KUTTY NAIR

Abstract

Background: Cerebro-pontine(CP) angle tumors usually present with symptoms of eight nerve and fifth nerve disturbance. Most studies found the incidence of them causing other cranial nerve palsies to be less than 3%.

Case presentation: A 51 year old male, recently diagnosed diabetic presented with binocular horizontal diplopia was found to have isolated left sixth nerve palsy. MRI revealed left CP angle mass extending into ipsilateral auditory canal suggestive of vestibular schwannoma so the patient was referred to a neurologist and radiotherapy was initiated. Patient recovered after 2 months and remained asymptomatic for 6 months following which he presented with isolated right sixth nerve palsy Repeat MRI showed the left CP angle mass as before along with brainstem edema, with no similar findings on the right.

Conclusion: CP angle tumors presenting with isolated ipsilateral sixth nerve palsy is rare, and they presenting with isolated contralateral sixth nerve palsy is even rarer.