Mydriasis and Ophthalmoplegia in a 10-Year-Old Girl: A Diagnostic Predicament

Abstract

This case reports a 10-year-old girl who presented with sudden-onset diplopia and bilateral mydriasis following a recent upper respiratory infection. Ocular examination showed poor light response and mild abduction deficits. Initial low-resolution MRI was normal, but a high-resolution MRI revealed bilateral enhancement of the abducens and oculomotor nerves. Viral-induced cranial nerve palsies were suspected. The use of systemic steroids was considered but concerns about side effects in children led to a conservative approach. Patient achieved full recovery four months later. This case highlights the importance of high-resolution imaging in diagnosing cranial nerve palsies in children and raises questions about the role of corticosteroids in managing viral-induced neuropathies. Further research is needed to determine optimal treatment strategies for such cases.