Oculomotor Nerve Palsy as a Rare Presentation and First Sign of Multiple MyelomaCorrespondence Address :
Dr. Bijnya Birajita Panda,
Senior Resident, Department of Ophthalmology, AIIMS, Bhubaneswar, Odisha, India.
E-mail : firstname.lastname@example.org
Acquired oculomotor nerve palsy has varied aetiologies like vascular (diabetes, heart disease, atherosclerosis and posterior communicating artery aneurysm), space occupying lesions or tumours, inflammation, infection, trauma, demyelinating disease like Multiple sclerosis, autoimmune disorders such as Myasthenia gravis, postoperatively as a complication of neurosurgery, cavernous sinus thrombosis etc. Cranial Nerve palsies as one of the first symptoms of multiple myeloma have been reported sparsely in literature. We report a case of a 60-year-old woman who developed sudden onset right-sided pupil sparing oculomotor nerve palsy along with a tender swelling at right sternoclavicular joint. Cranial and orbital magnetic resonance imaging and cerebrospinal fluid examination demonstrated no abnormalities. Immunological investigations and histopathological analysis of sternoclavicular joint swelling confirmed the diagnosis of IgG type multiple myeloma. After confirmation of diagnosis we started her with appropriate chemotherapy, after which the palsy resolved within one month. The cause of the palsy was probably due to nerve ischemia due to hyper viscosity of the serum.
Hyperviscosity, Plasmacytoma, Third nerve palsy
Bijnya Birajita Panda, Sucheta Parija, Jyotiranjan Mallick, Susanta Pujahari. OCULOMOTOR NERVE PALSY AS A RARE PRESENTATION AND FIRST SIGN OF MULTIPLE MYELOMA. Journal of Clinical and Diagnostic Research [serial online] 2016 May [cited: 2018 Jul 19 ]; 10:ND01-ND03. Available from
Date of Submission: Oct 20, 2015
Date of Peer Review: Nov 25, 2015
Date of Acceptance: Dec 28, 2015
Date of Publishing: May 01, 2016
Financial OR OTHER COMPETING INTERESTS: None.
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