A Tetrad Catastrophe: Paraneoplastic Syndrome With Abducens Palsy, Intracranial Hypertension, and Optic Neuropathy in Primary Lung Cancer.

Venushia Chandran, Nurul Ain Masnon, Rona A Nasaruddin, Jemaima Che Hamzah, Adzleen Mohmood, Andik Fadilah Abdul Aziz

Abstract readCase Reports

In one paragraph

Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Venushia ChandranOphthalmology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, MYS.

Nurul Ain MasnonOphthalmology, Kuala Lumpur Hospital, Kuala Lumpur, MYS.

Rona A NasaruddinOphthalmology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, MYS.

Jemaima Che HamzahOphthalmology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, MYS.

Adzleen MohmoodOphthalmology, Hospital Sultan Abdul Aziz Shah, University of Putra Malaysia, Kuala Lumpur, MYS.

Andik Fadilah Abdul AzizNuclear Medicine, National Cancer Institute, Putrajaya, MYS.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We report a unique case of paraneoplastic syndrome (PS) associated with primary lung cancer. A 57-year-old woman experienced headaches and bilateral visual loss one month after the onset of isolated right abducens palsy. Examination revealed bilateral poor visual acuity (VA), papilledema, and persistent right abducens palsy. Neuroimaging was normal. Lumbar puncture revealed high cerebrospinal fluid (CSF) opening pressure and protein levels. She was started on acetazolamide and pulse methylprednisolone followed by oral corticosteroids. Her abducens nerve palsy resolved, but her VA deteriorated. Anti-Hu and anti-CV2 were positive. A positron emission tomography (PET) scan revealed primary lung cancer, and she died six months after her initial presentation. This case demonstrated that PS poses a diagnostic challenge and may be associated with poor prognosis.

Indexed as

abducens palsyintracranial hypertensionlung canceroptic neuropathyparaneoplastic syndrome

Identifiers

PMID39310393

DOI10.7759/cureus.67335

PMCPMC11412775

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