[abstract] WEBER'S SYNDROME AND SIXTH NERVE PALSY SECONDARY TO DECOMPRESSION ILLNESS: CASE REPORT

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[abstract] WEBER'S SYNDROME AND SIXTH NERVE PALSY SECONDARY TO DECOMPRESSION ILLNESS: CASE REPORT

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Title: [abstract] WEBER'S SYNDROME AND SIXTH NERVE PALSY SECONDARY TO DECOMPRESSION ILLNESS: CASE REPORT
Author: Padilla, W; Newton, HB; Barbosa, S
Abstract: BACKGROUND: Weber's Syndrome is characterized by the presence of an oculomotor nerve palsy and contralateral hemiparesis or hemiplegia, and is caused by damage to the rostral brainstem. Herein we describe the first case of Weber's Syndrome to present as a complication of decompression illness in a recreational scuba diver. CASE REPORT: The patient was a 55 year-old male with a past medical history of a biopsied pulmonary cyst, in whom symptoms developed after a multilevel drift dive to a depth of 89 feet for 53 minutes. The dive exceeded no-decompression limits (NDL) and required a decompression stop at 20 feet for 13 minutes, as dictated by the patient's dive computer. Symptoms developed within 30 minutes of surfacing and included a left-sided Weber's Syndrome, a left sixth nerve palsy, dizziness, nausea, sensory loss, and ataxia. The patient was promptly treated with a series of two U. S. Navy Treatment Table 6 (USNTT6) and two USNTT5 sessions over four days, with complete resolution of all neurological symptoms and examination findings. DISCUSSION: The neurological injury localized to the left rostral ventromedial midbrain and underlying upper pons, and did not follow a strict vascular distribution. Although the mechanism of injury remains unclear, it involved features that were consistent with both air gas embolism (AGE) and decompression sickness (DCS). The dive exceeded NDL and was accompanied by an inadequate decompression stop, thereby increasing the risk for DCS. Similarly, the risk of AGE was increased by the presence of the pulmonary cyst and the potential for cystic micro-rupture. CONCLUSION: Prompt recognition and treatment of DCI can increase the likelihood of clinical improvement. Individuals with a pre-existing pulmonary cyst are at increased risk for dive-related complications and should approach diving with caution.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/1553
Date: 2004

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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