PARAPHARYNGEAL MASS MASQUERADING AS ABDUCENS PALSY : A CASE REPORT

Abstract

We report a case of a 27 year old male who came with complaints of sudden onset binocular, horizontal diplopia for 5 days worsening on left gaze .He also had history of dysphagia since 5 days.He was diagnosed as TB cervical lymphadenitis and was on ATT past 5 months.He was known case of type1 diabetes mellitus since 9 years,on treatment. OCULAR EXAMINATION:left sided face turn ,anterior segment and fundus examination were normal in Right eye.Left eye showed 15 degree esotropia,normal anterior segment with abduction restriction(-4),normal fundus examination.Visual acuity was 6/6 in both eyes.Colour vision and Corneal sensation normal in both eye. Other cranial nerves examination were normal. INVESTIGATION : MRI neck and brain showed large diffuse suprahyoid neck mass involving oropharynx and nasopharynx with intracranial extension in prepontine cistern and cavernous sinus. Diagnosed as left lateral rectus palsy due to parapharyngeal mass and referred to oncologist which was later confirmed as nasopharyengeal carcinoma.CONCLUSION : This case emphasize importance of neurological evaluation with imaging in an isolated cranial nerve palsy.