# Transient recurrent episodes of abducens nerve palsy and cheiro-oral syndrome in a sub-occlusive carotid bulb atherosclerotic stenosis

## TL;DR

A 50s male with transient neurological symptoms was found to have a carotid artery issue and underwent surgery, preventing further issues.

## Contribution

This case highlights sub-occlusive carotid bulb stenosis as a cause of transient neurological symptoms.

## Key findings

- The patient had transient episodes of cheiro-oral paresthesias and binocular diplopia.
- Carotid endarterectomy resolved the issue with no further cerebrovascular events after one year.

## Abstract

We report the case of a male in his 50s with a history of smoking admitted to our hospital for three transient recurrent episodes of less than 60 min of cheiro-oral paresthesias and binocular horizontal diplopia with convergent strabismus. On admission, his neurological examination was normal. Cerebral magnetic resonance imaging showed no cerebral lesion. Computed tomography angiography showed a sub-occlusive right carotid bulb atherosclerotic stenosis, the absence of abnormality of the subclavian arteries and the origin of the vertebral arteries, and no stenosis of the basilar artery or posterior cerebral arteries. Routine blood tests were normal with glycated hemoglobin of 6.5%. The patient underwent right carotid endarterectomy. One year after carotid endarterectomy, the patient has had no other cerebrovascular events.