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Related Experiment Videos

Isolated painful third nerve palsy.

Luis M Tumialán1, Patricia Hudgins, Valérie Biousse

  • 1Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA.

Reviews in Neurological Diseases
|April 6, 2006
PubMed
Summary

Steroids effectively treated a painful third nerve palsy caused by an intrinsic nerve lesion. This case highlights the management of isolated third nerve palsies.

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Area of Science:

  • Neuro-ophthalmology
  • Neurology

Background:

  • Isolated third nerve palsies can present with varied etiologies.
  • Pupil-involving third nerve palsies raise concern for compressive lesions, such as aneurysms.

Observation:

  • A 50-year-old woman experienced acute, painful, complete third nerve palsy with pupillary involvement.
  • Noninvasive imaging excluded aneurysm compression; MRI revealed an intrinsic third nerve lesion.
  • Initial work-up yielded no specific cause.

Findings:

  • Symptoms and signs resolved completely following corticosteroid administration.
  • The case suggests an inflammatory or demyelinating process as a potential cause.

Implications:

  • This case underscores the importance of considering inflammatory etiologies in pupil-involving third nerve palsies.
  • Steroid therapy can be a crucial management option for specific cases of third nerve palsy.
  • Prompt diagnosis and appropriate treatment are essential for favorable outcomes in third nerve palsies.

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