Orbital signs of parasellar syndromes

Abstract

Retro-orbital pathology involving the parasellar region can cause signs and symptoms that can be mistaken for orbital disease. Patients can present with a combination of proptosis, eyelid edema and erythema, chemosis, vision loss, numbness, and ophthalmoplegia with or without pain. A retro-orbital process should be considered when ophthalmoplegia is more consistent with a cranial neuropathy affecting the oculomotor nerve (CN 3), trochlear nerve (CN 4), or abducens nerve (CN 6) rather than extraocular muscle limitation. They have been divided anatomically into the superior orbital fissure syndrome (SOFS), orbital apex syndrome (OAS), or cavernous sinus syndrome (CSS).