Published in:
01-01-2019 | Imaging in Intensive Care Medicine
A case of acute respiratory distress syndrome with sixth cranial nerve palsy
Published in: Intensive Care Medicine | Issue 1/2019
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A 56-year-old man with a history of cigarette smoking was admitted to our intensive care department for pneumonia-related oxygen dependence. Two weeks previously (during a vacation in the countryside), the patient had developed confusion, headaches with photophobia, diplopia and fever. A neurological examination revealed drowsiness and binocular diplopia caused by left sixth cranial nerve palsy (Fig. 1a, b). Following lumbar puncture, bacterial cultures and PCR assays of the cerebrospinal fluid were negative. Magnetic resonance imaging of the brain was unremarkable.
Fig. 1
a Ocular motility photographs, showing impaired abduction of the left eye (right panel). b Measurements from sequential Lancaster red-green tests, confirming the impairment of abduction in the left eye. T temporal, N nasal. c An X-ray of the chest revealing the bilateral diffuse whiteout characteristic of acute respiratory distress syndrome
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