Ocular Bobbing in Brain Metastasis
A 47-year-old female presented with complaints of eye pain OU. She was bedridden and very weak and had a significant history of breast cancer with brain metastasis. Ophthalmic consultation showed that there was lagophthalmos in both eyes. Her visual acuity was unable to be assessed due to her poor general condition. There were mild cataracts in both lenses. Her eyeballs were soft by digital examination. A Hirschberg test showed a mild degree of esotropia. Extraocular movements showed ocular bobbing on primary gaze, with severe limitation of horizontal gaze (Fig. 39.1, Video 39.1). MR imaging revealed multiple lesions in the bilateral cerebral hemispheres and cerebellar hemispheres, with an enhancing metastatic lesion over the dorsal pontine region (Fig. 39.2). She received whole brain radiotherapy and chemotherapy and was then discharged with stable conditions. She was lost to follow-up 4 months later.
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