For instance, a patient with mild inferior rectus muscle
weakness might have a hypertropia on down gaze, but none in the primary position of gaze, whereas in complete CN III palsy, the patient may experience complete ptosis, the eye involved is deviated downward, outward and it is unable to adduct, infraduct, or even supraduct.
In patients with medial and inferior rectus muscle
sparing oculomotor fascicular paresis, physicians should consider the presence of an MLF lesion.
CT scan showed obvious enlargement of the inferior rectus muscle
of the left eye (Figure 1(c)).
riMLF: rostral interstitial nucleus of medial longitudinal fasciculus, iNC: interstitial nucleus of Cajal, CCN: caudal central subnucleus, MLF: medial longitudinal fasciculus, III N: oculomotor nucleus, VI N: abducens nucleus, IO: intraocular muscles, SR: superior rectus muscle, MR: medial rectus muscle, Lid: Levator palpebrae superioris muscle, IR: inferior rectus muscle
, and pupil: sphincter pupillae muscles.
Most involve injury to the medial rectus muscle via violation of the lamina papyracea, while the orbital floor and adjacent inferior rectus muscle
is generally not considered a high-risk area .
Additionally, the orbital floor fracture occurred just immediately behind the equator of the globe, that is, at the main bulk of the inferior rectus muscle
. However, its muscle height-to-width ratio remained intact.
The inferior rectus muscle
is most commonly affected, followed by the medial rectus muscle [1, 2].
The Inferior Rectus muscle
showed minimal fibrosis.
Biopsy was performed, and histopathological examinations of the biopsies of the inferior rectus muscle
of her left eye and the parotid gland on the right side showed an infiltration of atypical cells into the tissues.