DR Medhat MRCP

Petrous apex syndrome :
• Causes :
1) Tumors : meningioma ,nasopharyngeal carcinoma
2) Infection : petrous osteitis (Gradenigo syndrome)
3) Cholesterol granuloma : e.g after skull trauma.
• Features :
Unilateral abducence (6 th )nerve palsy : e.g binocular horizontal diplopia +
Ipsilateral facial pain & numbness (trigeminal sensory affection)
Insidious onset.
مهم جدا Conjugate gaze and its abnormalities
- The ocular motor system has one purpose to place & maintain the images of regard
on the fovea ,this is made by conjugate eye movement to prevent diplopia.
- The control of eye movements is mediated through multiple neural circuits that
interconnect cortex , basal ganglia, vestibular nuclei, cerebellum & ocular motor
nuclei in the brain stem.
- The ocular motor system consists of supranuclear, internuclear & nuclear
components.
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