MRI Results of Patients with Acute Isolyted Cranial Nerve Palsies

To investigate the magnetic resonance imaging (MRI) results of patients complaining from diplopia with ocular nerve palsy.

A routine ophthalmic examination was performed, a neurological consultation was requested, and cranial MRI was performed for all patients. The image results were sorted into four groups: ischemic lesions, demyelinating disease lesions, tumors, and no lesions. White matter gliosis and cerebral infarcts were included in the ischemic lesion group. The medical histories of the patients were acquired from medical records. The chi-squared test was used to analyze the relationship between age and cranial MRI images and to analyze the relationship between the image and paresis type. The statistical significance threshold was set at p < 0.05, unless otherwise stated.

Ischemic MRI images were the most common image type seen in our study. Third nerve paresis was significantly correlated with ischemic cerebral lesions observed by MRI (p=0.009). Furthermore, lesions were significantly correlated with patients aged above 50 years (p=0.004). There were no significant correlations between fourth or sixth nerve paresis and cranial ischemic images (p=0.680 and p=0.678, respectively). There were two instances of cerebral artery aneurysm, three instances of cerebral infarct, and one instance of intracranial mass, all in patients aged over 50 years.

Although our patients had minimal or nonexistent neurological symptoms, some had serious cranial pathologies. These pathologies were commonly seen in patients aged over 50 years. We recommend performing MRI on all patients with binocular diplopia.