Mild head injury with isolated third nerve palsy

Area of Science:

• Neuroscience
• Ophthalmology
• Trauma Surgery

Background:

• Traumatic cranial nerve palsies are typically linked to severe head trauma.
• Isolated cranial nerve palsies, especially from mild head injuries, are infrequent occurrences.

Observation:

• This report details a rare case of complete left third cranial nerve palsy (oculomotor nerve palsy).
• The palsy was associated with a mild head injury, challenging typical trauma-related neurological injury patterns.

Findings:

• Complete third nerve palsy demonstrated a slow and prolonged recovery process.
• Ptosis resolved over a 10-month period.
• The associated divergent squint necessitated intervention with botulinum toxin injection into the lateral rectus muscle, followed by surgical correction.

Implications:

• Mild head injuries can result in significant neurological deficits like third nerve palsy.
• Management of traumatic third nerve palsy requires a prolonged approach, potentially involving advanced treatments like botulinum toxin and surgery.
• This case highlights the importance of considering cranial nerve injuries even after seemingly minor head trauma.