{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T03:03:25Z","timestamp":1778900605029,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2007,10,1]],"date-time":"2007-10-01T00:00:00Z","timestamp":1191196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2007,10,1]],"date-time":"2007-10-01T00:00:00Z","timestamp":1191196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["OVS"],"published-print":{"date-parts":[[2007,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose.<\/jats:title>\n                    <jats:p>Chiari I malformations are rare, congenital anomalies involving the caudal herniation of the cerebellar tonsils into the upper cervical spinal canal. Osseous abnormalities of the skull permit the extension of the hindbrain below the foramen magnum and engender syringohydromyelia formation. Neuroophthalmic manifestations are not uncommon; nevertheless, this is the first report of concomitant bilateral abducens palsies and facial nerve impairment as presenting manifestations of a Chiari I malformation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Report.<\/jats:title>\n                    <jats:p>A 30\u2010year\u2010old black female presented with a recent history of blurred vision and binocular diplopia in both left and right gazes. Headaches, dizziness, and orofacial sensorimotor impairments were noted in conjunction with the onset of her diplopia. No history of surgery, trauma, or systemic illness was elicited. Extraocular motility testing confirmed a complete bilateral abduction deficit. Additional cranial nerve testing revealed bilateral facial nerve weakness and tactile hypesthesia in the perioral region. No taste disturbances were reported. Nuclear magnetic resonance imaging studies revealed a Chiari I malformation with a syringohydromyelia formation in the vicinity of the patient's sixth cervical vertebrae. Foramen magnum decompression surgery was performed. Two months after surgery, abduction capacity was restored along with resolution of symptoms of perioral numbness and signs of facial weakness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion.<\/jats:title>\n                    <jats:p>Bilateral sixth nerve palsies are rare clinical commodities especially when they do not occur in isolation. Intracranial neoplams, trauma, subarachnoid hemorrhaging, demyelinating disease, and meningeal infarcts have all been shown to induce mixed cranial neuropathies. The concomitant bilateral abducens palsy and concomitant facial nerve weakness reported in this case represents an atypical and previously unreported presentation of a Chiari I malformation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/opx.0b013e318157c6c6","type":"journal-article","created":{"date-parts":[[2009,3,3]],"date-time":"2009-03-03T17:32:50Z","timestamp":1236101570000},"source":"Crossref","is-referenced-by-count":14,"title":["Bilateral Abducens Palsies and Facial Weakness as Initial Manifestations of a Chiari 1 Malformation"],"prefix":"10.1002","volume":"84","author":[{"given":"ANDREW","family":"PILON","sequence":"first","affiliation":[{"name":"Illinois College of Optometry Chicago Illinois"},{"name":"Southern California College of Optometry Fullerton California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"PAUL","family":"RHEE","sequence":"additional","affiliation":[{"name":"Illinois College of Optometry Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"TRICIA","family":"NEWMAN","sequence":"additional","affiliation":[{"name":"Illinois College of Optometry Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LEONARD","family":"MESSNER","sequence":"additional","affiliation":[{"name":"Illinois College of Optometry Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,10,1]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"115","volume-title":"Primary Eyecare in Systemic Disease","author":"Conto JE","year":"1995"},{"key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1097\/01376517-200104000-00005","article-title":"Chiari I malformation: clinical presentation and management","volume":"33","author":"Strayer A","year":"2001","journal-title":"J Neurosci Nurs"},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1097\/00006123-199905000-00105","article-title":"Arnold Chiari Type I malformation presenting as a trigeminal neuralgia: case report","volume":"44","author":"Rosetti P","year":"1999","journal-title":"Neurosurgery"},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.1016\/S0161-6420(99)90541-9","article-title":"Treatment of acute comitant esotropia in Chiari I malformation","volume":"106","author":"Weeks CL","year":"1999","journal-title":"Ophthalmology"},{"key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/S0022-3476(89)80283-5","article-title":"Chiari type I malformation in children","volume":"115","author":"Dure LS","year":"1989","journal-title":"J Pediatr"},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1097\/00006123-200103000-00044","article-title":"Spontaneous resolution of Chiari I malformation and syringomyelia: case report and review of the literature","volume":"48","author":"Klekamp J","year":"2001","journal-title":"Neurosurgery"},{"key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1097\/00007632-200207010-00015","article-title":"Chiari I malformation associated with syringomyelia and scoliosis: a twenty\u2010year review of surgical and nonsurgical treatment in a pediatric population","volume":"27","author":"Eule JM","year":"2002","journal-title":"Spine"},{"key":"e_1_2_7_9_1","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1159\/000120791","article-title":"Cerebral syrinx with Chiari I malformation","volume":"20","author":"Kanev PM","year":"1994","journal-title":"Pediatr Neurosurg"},{"key":"e_1_2_7_10_1","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/S1071-9091(97)80036-8","article-title":"Hindbrain herniation syndromes: the Chiari malformations (I and II)","volume":"4","author":"Cai C","year":"1997","journal-title":"Semin Pediatr Neurol"},{"key":"e_1_2_7_11_1","unstructured":"SiddiqiNH LaneFJ.Chiari 1 Malformations. eMedicine.com Inc. 2005. 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A manifestation of Chiari I malformation","volume":"4","author":"Passo M","year":"1984","journal-title":"J Clin Neuroophthalmol"},{"key":"e_1_2_7_13_1","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1080\/0268869021000016588","article-title":"Papilloedema as the sole presenting feature of Chiari I malformation","volume":"16","author":"Choudhari KA","year":"2002","journal-title":"Br J Neurosurg"},{"key":"e_1_2_7_14_1","doi-asserted-by":"crossref","first-page":"83","DOI":"10.3928\/0191-3913-19870301-08","article-title":"Acquired esotropia as initial manifestation of Arnold\u2010Chiari malformation","volume":"24","author":"Bixenman WW","year":"1987","journal-title":"J Pediatr Ophthalmol Strabismus"},{"key":"e_1_2_7_15_1","doi-asserted-by":"crossref","first-page":"363","DOI":"10.2176\/nmc.38.363","article-title":"Abducens nerve palsy caused by basilar impression associated with atlanto\u2010occipital assimilation","volume":"38","author":"Hirose Y","year":"1998","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"e_1_2_7_16_1","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1007\/s00776-003-0711-1","article-title":"Abducens nerve palsy as a rare complication of spinal surgery: a case report","volume":"8","author":"Nakagawa H","year":"2003","journal-title":"J Orthop Sci"},{"key":"e_1_2_7_17_1","doi-asserted-by":"crossref","first-page":"715","DOI":"10.2176\/nmc.31.715","article-title":"Foramen magnum decompression for syringomyelia associated with basilar impression and Chiari I malformation\u2014report of three cases","volume":"31","author":"Kohno K","year":"1991","journal-title":"Neurol Med Chir (Tokyo)"}],"container-title":["Optometry and Vision Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1097\/OPX.0b013e318157c6c6","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1097\/OPX.0b013e318157c6c6","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1097\/OPX.0b013e318157c6c6","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T09:23:18Z","timestamp":1774948998000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1097\/OPX.0b013e318157c6c6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,10]]},"references-count":16,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2007,10]]}},"alternative-id":["10.1097\/OPX.0b013e318157c6c6"],"URL":"https:\/\/doi.org\/10.1097\/opx.0b013e318157c6c6","archive":["Portico"],"relation":{},"ISSN":["1040-5488","1538-9235"],"issn-type":[{"value":"1040-5488","type":"print"},{"value":"1538-9235","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,10]]}}}