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- Abducens palsy
- facial palsy
- hereditary haemorrhagic telangiectasia
- vascular anomaly
- venous malformation
- clinical neurology
A 75-year-old man presented in 2009 with sudden onset of a right-sided peripheral facial palsy and diplopia due to palsy of the right abducens nerve. During the last 10 years he had developed a large number of small bluish, compressible, rubbery and painless nodules involving primarily the face and trunk (figure 1A,B). Nodules were also found affecting the oral mucosa. Despite being treated for arterial hypertension, he was in a good general condition. MR Imaging of the brain in 2005, ordered during the evaluation of a minor stroke, had revealed multiple vascular anomalies in both the cerebrum and cerebellum. A skin biopsy from nodules of the chest had shown irregular dilated and congested vascular spaces, consistent with a venous malformation (figure 1C). A second MRI …
Competing interests None.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.