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Isolated Ischemic Inferior Rectus Paresis Related to Patent Foramen Ovale.

José Alberto Reche-SainzPatricia Calleja-CastañoFernando Sarnago-CebadaRodrigo Gil-Manso
Published in: Neuro-ophthalmology (Aeolus Press) (2024)
Isolated paresis of the inferior rectus muscle (IRM) represents a rare occurrence. This case report involves a young adult male who, abruptly during a Valsalva maneuver, encountered acute vertical diplopia due to right IRM paresis, resolving spontaneously within a few hours. The patient presented without identifiable risk factors, and magnetic resonance imaging revealed a minor left thalamic ischemic lesion. A cardiac study identified the presence of a patent foramen ovale, potentially associated with a paradoxical embolism, indicating its likely role in this transient ischemic event.
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