| 본문 : The snake bite can cause the local and systemic complications. The ophthalmoplegia and diplopia following snake bite have been rarely reported in Korea. We report the case of a patient with unilateral oculomotor nerve palsy following snake bite. A 58-year-old male visited the emergency department with a complain of suddenly developed diplopia following snake bite. He was bitten on the right finger about 6 hours prior to the symptom by an unidentified snake. He did not have any neurologic symptoms such as such as headache, nausea, vomiting, and altered level of consciousness. Examination revealed fang marks with severe swelling and oozing with inflammation in the right finger. There was no ocular injection, chemosis, pain, or visual disturbance. The visual acuity was 20/25 in both eyes. There was ptosis in the right eye. The pupils showed normal response to both light and near stimulation. Extraocular examination revealed limitation of movement in all fields of gaze except abduction of the right eye. The pyridostigmine was prescribed, but did not lead to dramatic improvement of ocular symptoms. The ocular symptoms showed gradual improvement during follow-up. At the 8 months after the initial visit, he showed the ortho at the primary gaze with -1 of adduction limitation. |