Discussion

Neuro-ophthalmic is one of the ophthalmological manifestations in patients with

HIV/AIDS. There are rare reports of neuro-ophthalmological manifestations of HIV-infected
patients presenting with ophthalmoplegia and ptosis. The mechanism of neuro-ophthalmic
disorders develop is heterogeneous but there are at least 2 main ways to cause neuro-ophthalmic
disorders such as infected by the HIV virus itself or other factors. secondary infections such as
opportunistic infections or neoplasms and inflammatory processes.
Cerebral toxoplasmosis usually presents with subacute neurologic manifestations. The
most common signs and symptoms were headache (38%-93%), focal neurologic deficit (22%-
80%), fever (35%-88%), mental confusion (15%-52%), seizures (19 - 58%), psychomotor or
behavioral changes (37%-42%), cranial nerve palsy (12%-28%), ataxia (2%-30%), and visual
abnormalities (8%-19%). These manifestations are not all found in patients with cerebral
toxoplasmosis in HIV/AIDS patients. In this case report, the only manifestations that appeared
were ophthalmoplegia and ptosis with normal funduscopy. The process of ophthalmoplegia in
patients with cerebral toxoplasmosis is caused by cranial nerve palsy and due to opportunistic
infectious and inflammatory processes.
Although the manifestations of ophthalmoplegia in patients with cerebral toxoplasmosis
are rare and neglected. Through this case report, we hope to be able to think about neuro-
ophthalmic abnormalites caused by cerebral toxoplasmosis.