Supplementary data for: Abducens nerve palsy with ipsilateral excessive eye tearing attributed to internal carotid artery sympathetic plexus schwannoma

A 65-year-old man developed subacute horizontal diplopia due to
left-abducens nerve (AN) palsy and excessive left-eye tearing. Brain-MRI
revealed a hyperintense T2-lesion with an elongated course within the
left-carotid canal, presenting homogenous contrast-enhancement (Figure-1).
The imaging findings were characteristic for an internal-carotid-artery
sympathetic plexus (ICSP) schwannoma compressing the left-AN. Subsequent
irritation of the deep petrosal nerve originating directly from ICSP and
continuing as the vidian nerve may have led to the lacrimal gland edema
and excessive left-eye tearing (Figure-2). ICSP schwannoma represents an
uncommon cause of AN palsy that may also manifest with excessive
ipsilateral-eye tearing due to vidian nerve involvement.