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THE OCULAR SEQUELAE OF THIRD CRANIAL NERVE PALSY
Canadian Medical Association Journal
|October 26, 1963
Summary
Patients with third cranial nerve paralysis often have poor recovery, especially when caused by aneurysms. However, trauma or infections like herpes zoster can lead to full recovery of ocular function.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Third cranial nerve (oculomotor nerve) paralysis can result in significant ocular sequelae.
- Associated etiologies range from vascular issues like aneurysms to trauma and infections.
Purpose of the Study:
- To analyze the ocular sequelae and recovery patterns in patients with complete third cranial nerve paralysis.
- To investigate the impact of different etiologies on the prognosis of third nerve palsy.
Main Methods:
- Retrospective analysis of nineteen patients diagnosed with complete third cranial nerve paralysis.
- Categorization of patients based on the underlying cause: internal carotid artery aneurysm, trauma, herpes zoster ophthalmicus, encephalitis, or obscure etiology.
Main Results:
- Eleven patients with paralysis linked to internal carotid artery aneurysms showed no complete recovery; six achieved binocular single vision.
- Two cases of aneurysm-related paralysis exhibited aberrant regeneration.
- Four trauma-related cases had one complete recovery and one aberrant regeneration.
- Two cases with herpes zoster ophthalmicus, encephalitis, or obscure etiology fully recovered.
Conclusions:
- Third cranial nerve paralysis associated with internal carotid artery aneurysms has a poor prognosis for functional recovery.
- Trauma and infectious etiologies, such as herpes zoster ophthalmicus, are associated with a better prognosis for complete recovery.
- Aberrant regeneration is a potential sequela in cases of third nerve palsy, particularly those related to aneurysms.
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