A Case of Cryptococcal Meningitis with Bilateral Internuclear Ophthalmoplegia and Ptosis

ABSTRACT

A 73-year-old woman with long-term steroid medication for arthralgia, suffered a sudden decrement of mental status, bilateral internuclear ophthalmoplegia and ptosis. T2-weighted MR images revealed high signals in the midbrain and both thalami. In cerebrospinal fluid studies, a test for cryptococcal antigen was positive and Cryptococcus neoformans was cultured. Bilateral internuclear ophthalmoplegia and ptosis may develop in cryptococcal meningitis from ischemic complications.