Differential Diagnosis for Eom (Extraocular Movement) Abnormalities
Single Most Likely Diagnosis
- Thyroid Ophthalmopathy: This condition is a common cause of extraocular movement abnormalities, particularly in patients with a history of thyroid disease. It leads to restrictive myopathy, causing limitations in eye movements.
Other Likely Diagnoses
- Myasthenia Gravis: An autoimmune disorder that affects the neuromuscular junction, leading to fluctuating weakness of the extraocular muscles and resulting in abnormal eye movements.
- Cranial Nerve Palsies (III, IV, VI): These palsies can result from various causes such as diabetes, hypertension, or aneurysms, affecting the oculomotor, trochlear, and abducens nerves, respectively, and leading to specific patterns of extraocular movement abnormalities.
- Orbital Myositis: Inflammation of the extraocular muscles, which can cause pain, swelling, and restricted eye movements.
Do Not Miss Diagnoses
- Aneurysm (e.g., Posterior Communicating Artery Aneurysm): Although less common, an aneurysm pressing on the third cranial nerve can cause sudden onset of diplopia and extraocular movement abnormalities, which is a medical emergency.
- Cavernous Sinus Thrombosis: A rare but potentially life-threatening condition that can cause multiple cranial nerve palsies, including those affecting extraocular movements.
- Tolosa-Hunt Syndrome: A rare disorder characterized by inflammation of the cavernous sinus or superior orbital fissure, leading to painful ophthalmoplegia.
Rare Diagnoses
- Gradenigo’s Syndrome: A rare condition caused by inflammation of the petrous apex, leading to a combination of symptoms including extraocular movement abnormalities due to involvement of the cranial nerves.
- Moebius Syndrome: A congenital neurological disorder characterized by facial paralysis and impaired eye movements due to abnormal development of the sixth and seventh cranial nerves.
- Chronic Progressive External Ophthalmoplegia (CPEO): A rare mitochondrial disorder that leads to progressive weakness of the external eye muscles, resulting in bilateral ptosis and limited eye movements.