Pearls & Oy-sters: An isolated cranial nerve 6 palsy as a presentation of polycythemia vera.

Pearls and oy-sters: carotid dissection with normal arterial lumen.

Clinical presentation of carotid artery dissection (CAD) is variable, including acute or subacute headache, cervical pain, or focal neurologic deficit that occurs spontaneously, after a high-speed neck manipulation, or trauma. Isolated lower cranial nerve palsy in carotid dissection is uncommon.

Pearls & Oy-sters: polycythemia vera presenting with ischemic strokes in multiple arterial territories.

Pearls and oy-sters: central fourth nerve palsies.

CLINICAL PEARLS Lesions of the fourth (trochlear) cranial nerve cause vertical or oblique diplopia by impairing the ability of the superior oblique muscle to intort and depress the eye. This binocular diplopia worsens in downgaze and lateral gaze away from the affected eye. Because intorsion is necessary to maintain fusion in ocular counter-roll, this diplopia also worsens with head tilt toward...

Pearls & Oy-sters: A rare presentation of chronic intracranial hypertension with concurrent deafness and blindness.

• Auditory neuropathy is an uncommon presentation of elevated ICP, possibly due to stretch of the vestibulocochlear nerve from the increased ICP. • Petrous apex cephalocele and meningoceles are uncommon radiologic features of elevated ICP. • Ischemic central retinal vein occlusion is a rare ophthalmologic manifestation of elevated ICP that may cause irreversible vision loss if the increased ICP...

A Rare Presentation of Isolated Oculomotor Nerve Palsy due to Multiple Sclerosis in a Child

     Multiple sclerosis (MS) is an inflammatory, demyelinating, neurodegenerative disorder of the central nervous system (CNS) of unknown etiology. Isolated oculomotor nerve palsy is found rarely in children with MS. We present a case of MS in 10-year-old boy, who had bilateral ptosis associated with medial gaze restriction. The extraocular muscle examination demonstrated bilateral adduction pa...