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Journal of Medical Case Reports
Published in: Journal of Medical Case Reports 1/2023

Open Access 01-12-2023 | Ophthalmoparesis | Case report

Transient lateral rectus palsy associated with acute coronary syndrome treated with percutaneous coronary intervention: a case report

Authors: Ali Asghar Farsavian, Mahya Mobinikhaledi, Parastoo Ghorbani, Erfan Ghadirzadeh

Published in: Journal of Medical Case Reports | Issue 1/2023

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Abstract

Background

Patients who experience angina and acute myocardial infarction often receive diagnostic coronary angiography and percutaneous coronary intervention.

Case presentation

A 54-year-old Persian man with acute coronary syndrome was admitted to the hospital and underwent elective percutaneous coronary intervention. Two hours after the procedure, the patient experienced ophthalmoplegia and diplopia. The diagnosis was abducens nerve palsy resulting in transient lateral rectus palsy. The cause is presumed to have been an ischemic event affecting the unilateral abducens nerve. This could have occurred owing to the microembolism during the percutaneous coronary intervention, which resulted in left lateral rectus palsy. Within 1 month, the diplopia was relieved completely, and the physical examination was normal.

Conclusion

The occurrence of neuro-ophthalmic complications that may arise from percutaneous coronary intervention is extremely rare. To our knowledge, this is the second reported case of unilateral rectus palsy associated with percutaneous coronary intervention.
Literature
1.
Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y. Heart disease and stroke statistics—2022 update: a report from the American Heart Association. Circulation. 2022;145:e153–639.CrossRefPubMed
2.
O’Neill WW, Brodie BR, Ivanhoe R, Knopf W, Taylor G, O’Keefe J, Grines CL, Weintraub R, Sickinger BG, Berdan LG. Primary coronary angioplasty for acute myocardial infarction (the Primary Angioplasty Registry). Am J Cardiol. 1994;73:627–33.CrossRefPubMed
3.
Lau E, Ilsen P. Ophthalmic complications of coronary revascularization: a review of literature. Clin Refract Optom Online. 2015;26:1.
4.
Kojuri J, Mehdizadeh M, Rostami H, Shahidian D. Clinical significance of retinal emboli during diagnostic and therapeutic cardiac catheterization in patients with coronary artery disease. BMC Cardiovasc Disord. 2011;11:1–6.CrossRef
5.
Lemos J, Meira D. Distúrbios supra e internucleares da motilidade ocular; Neuroftalmologia baseada na evidência. Neuroftalmologia baseada na evidência Lisboa: Sociedade Portuguesa de Oftalmologia. 2014.
6.
Eggenberger ER, Desai NP, Kaufman DI, Pless M. Internuclear ophthalmoplegia after coronary artery catheterization and percutaneous transluminal coronary balloon angioplasty. J Neuroophthalmol. 2000;20:123–6.CrossRefPubMed
7.
Drummond G, Wuebbolt G. Bilateral ophthalmoplegia during percutaneous transluminal coronary angioplasty. Can J Ophthalmol. 1990;25:152–5.PubMed
8.
Teitelbaum BA. Asymptomatic unilateral microembolic retinopathy secondary to percutaneous transluminal coronary angioplasty. J Am Optom Assoc. 1999;70:587–92.PubMed
9.
Ati H. Isolated sixth nerve palsy from pontine infarct. Acta Neurol Belg. 2000;100:246–7.
10.
Fukutake T, Hirayama K. Isolated abducens nerve palsy from pontine infarction in a diabetic patient. Neurology. 1992;42:2226–2226.CrossRefPubMed
11.
Shivaraju A, Yu C, Kattan MW, Xie H, Shroff AR, Vidovich MI. Temporal trends in percutaneous coronary intervention-associated acute cerebrovascular accident (from the 1998 to 2008 Nationwide Inpatient Sample Database). Am J Cardiol. 2014;114:206–13.CrossRefPubMedPubMedCentral
12.
Bladin CF, Bingham L, Grigg L, Yapanis AG, Gerraty R, Davis SM. Transcranial Doppler detection of microemboli during percutaneous transluminal coronary angioplasty. Stroke. 1998;29:2367–70.CrossRefPubMed
13.
Spina R, Simon N, Markus R, Muller DW, Kathir K. Contrast-induced encephalopathy following cardiac catheterization. Catheter Cardiovasc Interv. 2017;90:257–68.CrossRefPubMed
14.
Spina R, Simon N, Markus R, Muller DW, Kathir K. Recurrent contrast-induced encephalopathy following coronary angiography. Intern Med J. 2017;47:221–4.CrossRefPubMed
15.
Law S, Panichpisal K, Demede M, John S, Marmur JD, Nath J, Baird AE. Contrast-induced neurotoxicity following cardiac catheterization. Case Rep Med. 2012; 2012.
16.
Guimaraens L, Vivas E, Fonnegra A, Sola T, Soler L, Balaguer E, Medrano J, Gandolfo C, Casasco A. Transient encephalopathy from angiographic contrast: a rare complication in neurointerventional procedures. Cardiovasc Intervent Radiol. 2010;33:383–8.CrossRefPubMed
17.
Lantos G. Cortical blindness due to osmotic disruption of the blood–brain barrier by angiographic contrast material: CT and MRI studies. Neurology. 1989;39:567–567.CrossRefPubMed
18.
Vasavada A, Parekh P, Agrawal N, Vinchurkar M. Rare occurrence of a transient isolated unilateral partial third nerve palsy after angioplasty. Case Rep. 2013;2013:bcr2013201826.
19.
Yu J, George Dangas M. New insights into the risk factors of contrast-induced encephalopathy. J Endovasc Ther. 2011;18:545.CrossRefPubMed
20.
Caille J-M, Gioux M, Arne P, Paty J. Neurotoxicity of nonionic iodinated water-soluble contrast media in myelography: experimental study. Am J Neuroradiol. 1983;4:1185–9.PubMedPubMedCentral
21.
Potsi S, Chourmouzi D, Moumtzouoglou A, Nikiforaki A, Gkouvas K, Drevelegas A. Transient contrast encephalopathy after carotid angiography mimicking diffuse subarachnoid haemorrhage. Neurol Sci. 2012;33:445–8.CrossRefPubMed
22.
Fang HY, Kuo YL, Wu CJ. Transient contrast encephalopathy after carotid artery stenting mimicking diffuse subarachnoid hemorrhage: a case report. Catheter Cardiovasc Interv. 2009;73:123–6.CrossRefPubMed
23.
Gürer B, Yilmaz ER, Kahveci R, Sekerci Z. Non-ionic contrast media neurotoxicity mimicking intracerebral hematoma. Acta Neurochir. 2011;153:419–20.CrossRefPubMed
24.
Nelson M, Bartlett R, Lamb J. Seizures after intravenous contrast media for cranial computed tomography. J Neurol Neurosurg Psychiatry. 1989;52:1170–5.CrossRefPubMedPubMedCentral
25.
Kuhn MJ, Burk TJ, Powell FC. Unilateral cerebral cortical and basal ganglia enhancement following overdosage of nonionic contrast media. Comput Med Imaging Graph. 1995;19:307–11.CrossRefPubMed
26.
Fujioka T, Sugimoto H, Kinoshita M. Isolated abducens nerve palsy caused by pontine infarction. Rinsho Shinkeigaku = Clin Neurol. 1992;32:541–2.
Metadata
Title
Transient lateral rectus palsy associated with acute coronary syndrome treated with percutaneous coronary intervention: a case report
Authors
Ali Asghar Farsavian
Mahya Mobinikhaledi
Parastoo Ghorbani
Erfan Ghadirzadeh
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2023
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-023-04124-4

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