MRI findings of contralateral oculomotor nerve palsy in Parry-Romberg syndrome()

PURPOSE: To study a case of right Parry Romberg syndrome associated with contralateral oculomotor nerve palsy using high-resolution cerebral and orbital magnetic resonance imaging (MRI). OBSERVATIONS: There were no brain MRI abnormalities. However, there was marked enophthalmos on the right with reduction of orbital fat. Extraocular muscles contracted normally in the right eye, but in the left eye, there was reduced contractility of the medial, inferior, and superior rectus muscles. The intraorbital motor nerves were unremarkable bilaterally, and the right optic nerve was tortuous. CONCLUSIONS AND IMPORTANCE: Parry Romberg syndrome is a disease of unknown etiology with various ophthalmologic manifestations. This case study contributes extensive MRI data to the limited literature on ophthalmological anatomic findings in a patient who had Parry Romberg syndrome with contralateral paralytic strabismus.