We present a case of bilateral oculomotor nerve paralysis induced by alpha II-interferon in a patient with hairy-cell leukemia. After the drug was withdrawn, the neurological abnormalities disappeared. [ncbi.nlm.nih.gov]

Sphenoid sinus mucocoele presenting with isolated oculomotor nerve palsy. J Laryngol Otol. 1997 5;111(5):471–473. PMID: 9205613. 10. Lin CJ, Kao CH, Kang BH, Wang HW. Frontal sinus mucocele presenting as oculomotor nerve palsy. [e-ceo.org]

• Nausea

  The oculomotor nucleus, located in the midbrain, can be affected if the blood supply to the midbrain is decreased. 6 Patients may also present with nausea, vertigo, and other cranial nerve or neurologic deficits. [aafp.org]

  There may be associated symptoms such as ptosis, eye pain (with or without eye movement), headache and nausea. Signs/examination Check for ptosis, which is often the first sign of weakness. [patient.info]

  · Vertigo and nausea: They are partly due to diplopia, and partly due to false orientation. · Secondary angle of deviation is more than the primary deviation. · Restriction of ocular movements in the direction of action of paralyzed muscle. · Compensatory [thamburaj.com]

• Diplopia

  The term 'Diplopia' is derived from the Greek; diplous meaning double and ops meaning eye. Diplopia causes significant difficulty with depth perception and orientation of objects. [thamburaj.com]

  […] not appreciate diplopia when overcorrect until 50Δ BI 8. 4. [slideshare.net]

  Diplopia was relieved by performing surgery in both the affected eye (right medial rectus resection) and the healthy eye (left lateral rectus muscle recession). [jeos.eg.net]

  Diplopia may be a complication after refractive surgery. Ocular lesions, including diplopia, can be amongst the presenting features of Creutzfeldt-Jakob disease (CJD), especially new variant CJD [ 4 ]. [patient.info]

  A 53-year-old man presented to the emergency department with diplopia, left-sided ptosis, unsteady gait, headache, and left eye pain that had persisted for four days. [aafp.org]

• Strabismus

  […] due to nerve palsy ( H49.0 - H49.2 ) Strabismus (congenital) (nonparalytic) H50.9 ICD-10-CM Diagnosis Code H50.9 Unspecified strabismus 2016 2017 2018 2019 Billable/Specific Code paralytic H49.9 ICD-10-CM Diagnosis Code H49.9 Unspecified paralytic strabismus [icd10data.com]

  J Pediatr Ophthalmol Strabismus. 1991;28:10–13. Salazar-León JA, Ramírez-Ortíz MA, Salas-Vargas M. The surgical correction of paralytic strabismus using fascia lata. J Pediatr Ophthalmol Strabismus. 1998;35:27–32. [healio.com]

  Paralytic strabismus poses a significant diagnostic and therapeutic challenge. [1] The prevalence of paralytic strabismus is variable in different studies. [jovr.org]

  Two common ones are Strabismus - a disorder in which the two eyes don't line up in the same direction. This results in "crossed eyes" or "walleye." [icdlist.com]

  The surgical correction of paralytic strabismus using fascia lata. J Pediatr Ophthalmol Strabismus 1998; 35:27-32 Goldberg RA, Rosenbaum AL, Tong JT. Use of apically based periosteal flaps as globe tethers in severe paretic strabismus. [djo.org.in]

• Unilateral Ptosis

  A few key points once more: The oculomotor palsy is characterized by unilateral ptosis and an eye that is down and out. Pupil dilation suggests compression, possibly by berry aneurysm. [eyes.gp-surgery.com]

  Other patterns of weakness cannot occur with nuclear lesions, such as III nerve palsy with unilateral ptosis or unilateral mydriasis. [neuroophthalmology.ca]

  Inferior rectus Also contain parasympathetic fiber for the ciliary and sphincther of the pupil muscles. [ 12, 23, 24, 25 ] Clinical deficit Signs and symptoms The patient will usually present with sudden onset unilateral ptosis (or rarely, a bilateral [ispub.com]

  Thus, unilateral ptosis indicates that only the brainstem fascicles were affected. [frontiersin.org]

• Painful Ophthalmoplegia

  Most common causes are tumor (e.g. meningiomas) There is another described pathology within the cavernous sinus and superior orbital fissure that presents with painful ophthalmoplegia known as Tolosa Hunt Syndrome. [eyewiki.aao.org]

  ophthalmoplegia due to granulomatous lesion in cavernous sinus [thamburaj.com]

  Aneurysms arising at the junction of posterior communicating artery and middle cerebral arteries can affect the nerve by compression or acute hemorrhage resulting in acute painful ophthalmoplegia. [djo.org.in]

• Blepharoptosis

  Equal size pupils without blepharoptosis (top) in the interval between attacks of left-sided blepharoptosis, and maximally enlarged pupil during an attack (bottom, arrow) (with written permission of the patient). [frontiersin.org]

  Keywords : Blepharoptosis ; Mucocele ; Oculomotor nerve INTRODUCTION A mucocele is a slowly progressing benign lesion caused by the retention of mucous secretions and expansion due to the continuous obstruction of the orifice of the sinus or a minor salivary [e-ceo.org]

  Generally, patients present with blepharoptosis, limitation in eye movements accompanied by strabismus and a dilated pupil reacting to light. [9] Most reports have stated ischemia as the most common cause of the oculomotor nerve paralysis. [4], [5] Although [jovr.org]

• Stroke

  […] selectively affects somatic fibers over parasympathetic fibers, while traumatic stroke affects both types more equally. [en.wikipedia.org]

  Keywords Nerve Palsy Hemorrhagic Stroke Cranial Nerve Nucleus Oculomotor Function Thalamic Stroke Introduction Cases of stroke that result in isolated third nerve palsy without other significant non-ocular signs are rare. [jmedicalcasereports.biomedcentral.com]

  Bilateral Fascicular Third Nerve Palsy in Posterior Circulation Stroke. Neuro-Ophthalmology, p. 1. CrossRef Google Scholar Fu, Qichang Guan, Sheng Liu, Chao Wang, Keyan and Cheng, Jingliang 2018. [cambridge.org]

  […] myeloma (in remission) Asthma Seasonal allergies Medications: Infection prophylaxis (acyclovir, butenafine, trimethoprim-sulfamethoxazole) Multiple myeloma remission maintenance (prednisone 5 mg twice a day) Family History: Mother: thyroid cancer Father: stroke [eyerounds.org]

  These include vascular conditions such as strokes or aneurysms, space-occupying lesions in the orbit or skull (neoplastic or vascular), migraine or any cause of raised intracranial pressure. [patient.info]

• Cranial Nerve Involvement

  Lower cranial nerve involvement, leading to respiratory, swallowing, and cardiac difficulties, was also present. Pathologic examination of the brainstem showed absent or hypoplastic third, seventh, tenth, and twelfth nerve nuclei. [ncbi.nlm.nih.gov]

If carcinomatous meningitis is diagnosed on cerebrospinal fluid workup, then a search for systemic metastatic disease, an occult primary carcinoma, lymphoma, or leukemia is warranted. [emedicine.medscape.com]

Nevertheless, basic workup must be done. [eyewiki.aao.org]

Antibody—negative Toxoplasma PCR—negative Varicella Zoster PCR—negative Urine Studies Histoplasma Antigen Assay—negative Imaging Studies MRI brain with contrast, MRA head with contrast CT chest/abdomen/pelvis with contrast Transesophageal Ultrasound The workup [eyerounds.org]

[…] changes in the biochemical environment arising from head trauma, have been suggested in these cases. 7 While relatively uncommon, cases of isolated ONP should be viewed by clinicians as suggestive of additional neurological injury and in need of further workup [dovepress.com]

Acute palsy in individuals less than 40 years of age suggests need for neuroimaging and a complete neurological workup. Common cause of isolated oculomotor nerve involvement is intracranial aneuryms. [djo.org.in]

In this article, we present the case of a 9-year-old girl who developed unilateral nerve paralysis as a secondary complication of neurobrucellosis and recovered without sequel after treatment. [ncbi.nlm.nih.gov]

Helps you make optimal use of the newest drug therapies, including Anti-VEGF treatment for wet ARMD and bevacizumab treatment for complications of diabetes. [books.google.com]

Clinical characteristics of primary paranasal sinus mucoceles and their surgical treatment outcome. Korean J Otolaryngol-Head Neck Surg. 1998 11;41(11):1436–1439. 7. Friedmann G, Harrison S. [e-ceo.org]

Compressive lesions (eg, aneurysm or tumor) that are treated endovascularly or surgically may also improve or resolve following treatment. [emedicine.com]

Medical intervention was conducted following the Optic Neuritis Treatment Trial (ONTT) guidelines. [ingentaconnect.com]

Prognosis The prognosis of an oculomotor palsy depends on the etiology. Posttraumatic, postinfectious, postinflammatory, and ischemic oculomotor palsies may partially or completely recover spontaneously. [emedicine.com]

Causes and prognosis in 4278 cases of paralysis of the oculomotor, trochlear, and adbucens cranial nerves. Am J Ophthalmol. 1992;113:489–496. PubMed Google Scholar 9. Rush JA, Younge BR. Paralysis of cranial nerves III, IV. and VI. [link.springer.com]

Risk Factors and prognosis of isolated ischemic third, fourth, or sixth cranial nerve palsies in the Korean population. J Neuroophthalmol 2015;35:37–40. 13. Gross G, Schöfer H, Wassilew S, et al. [synapse.koreamed.org]

Prognosis : guarded. Pathogenesis Etiology Inflammatory diseases, eg distemper Canine distemper disease, granulomatous meningoencephalitis Granulomatous meningoencephalomyelitis. Space occupying lesions, eg neoplasia Brain: neoplasia. [vetstream.com]

Epidemiology Frequency United States Oculomotor nerve palsy is uncommon, and its frequency varies depending on the etiology. [emedicine.com]

No ophthalmological or neurological etiologies were apparent. A mucocele of the right posterior ethmoid sinus was observed with radiology. [e-ceo.org]

Etiology Clinical features Extorsion of the eye : inability to depress and adduct the eyeball simultaneously (the pupil shoots upward during attempted adduction of the eyeball) Diplopia ( double vision ) Mild esotropia Trigeminal nerve lesion (V) Etiology [amboss.com]

The most common known etiology is a posterior communicating artery aneurysm. This is a medical emergency. [eyewiki.aao.org]

/-aberrant regeneration (common) /-cyclic oculomotor spasm significant risk of amblyopia Acquired Third Nerve Palsy uncommon usually unilateral etiology: trauma (more common in children) neoplasm (primary or metastatic tumor) aneurysm (more common in [www2.medicine.mcgill.ca]

This study was performed to determine epidemiologic and etiologic distribution and results of strabismus surgery in patients with third nerve palsy referred to our clinic as a tertiary center over a 10-year period. [jovr.org]

Epidemiology in glaucoma. In: Yanoff M, Duker JS, eds. Ophthalmology. 2nd ed. St Louis: Mosby Elsevier, 2009:1017-1019. 3. Fraser S, Wormald R. Epidemiology in glaucoma. In: Yanoff M, Duker JS, eds. Ophthalmology. 2nd ed. [cmej.org.za]

Epidemiology Frequency United States Oculomotor nerve palsy is uncommon, and its frequency varies depending on the etiology. [emedicine.com]

Epidemiology Adie’s tonic pupil occurs in a 3:1 female to male ratio with an average age of onset of 32 years.[1] General Pathology It is thought that either a bacterial or viral infection causes inflammation which damages neurons in the ciliary ganglion [neuro-ophthalmology.stanford.edu]

Diagnosis: Third Nerve Palsy with Contralateral Hemiplegia Secondary to Midbrain Fungal Abscess Epidemiology of a midbrain fungal abscess Immunocompromised Individuals Use of chronic immunomodulators Stem cell transplant Solid organ transplant Leukemia [eyerounds.org]

Pathophysiology Anatomy and function The oculomotor nerve serves two functions: Movement of the eye. Pupillary constriction. These functions are controlled by differing nuclear areas. [vetstream.com]

The pathophysiology of nerve palsy in the orbit caused by mucoceles is not well-known. [e-ceo.org]

In some cases, the precise site of the lesion is clear, whereas in others, the location of the lesion is speculative. [1] Pathophysiology To understand the pathophysiology of the oculomotor nerve palsy it is essential to know its track. [eyewiki.aao.org]

Pathophysiology The anatomical relationship of the various portions of the oculomotor (third) cranial nerve accounts for many of the clinical features of third cranial nerve palsy as outlined below. [emedicine.com]

Pathophysiology Histologic examination of patients with Adie’s Syndrome has shown a reduction of ciliary ganglion cells.[1] The affected short ciliary neurons are postganglionic parasympathetic neurons which synapse within the ciliary ganglion and innervate [neuro-ophthalmology.stanford.edu]

Echothiophate, by preventing acetylcholine hydrolysis, may have allowed this transmitter to accumulate and to produce miosis. [ncbi.nlm.nih.gov]

To further clarify, classically a posterior communicating artery aneurysm will cause compression of the entire third nerve and so prevent ANY nerve signal conduction thus affecting the somatic system and also the autonomic. [en.wikipedia.org]

Non-surgical treatments: patching in visually immature children to prevent amblyopia occlusion or prisms to relieve diplopia in visually mature individual (especially during the observation period) botulinum toxin injection of the antagonist muscle(s) [www2.medicine.mcgill.ca]

[…] persistence of the esodeviation – high suspicion of amblyopia. • Alternate occlusion prevents secondary contracture of muscles and also amblyopia. [cmej.org.za]

Prevention of ocular complications of herpes zoster ophthalmicus by adequate treatment with acyclovir. Klin Monbl Augenheilkd 1991;198:358–360. 12. Jung JS, Kim DH. [synapse.koreamed.org]