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Monocular elevator paresis in neurofibromatosis type 2

From the Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; the Department of Neurology, Massachusetts General Hospital; and the Harvard University Medical School, Boston, MA.

Address correspondence and reprint requests to Dr. Simmons Lessell, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114; e-mail: barbara_cote{at}meei.harvard.edu

A retrospective review of 29 consecutive unselected patients referred for neuro-ophthalmic evaluation after the diagnosis of neurofibromatosis type 2 (NF2) showed that four of them had a monocular elevator paresis. In two of the four MRI demonstrated lesions, presumed to be schwannomas, of the third nerve. These findings indicate that monocular elevator paresis is a common neuro-ophthalmic finding in NF2, which the authors suspect is probably a sign of third nerve infiltration or compression by a schwannoma.