Cranial nerve and eye muscle palsies

Chapter 83 Cranial nerve and eye muscle palsies

Congenital IIIrd nerve palsy: classification

Unilateral congenital IIIrd nerve palsy

A. Clinical features suggesting pre- or perinatal peripheral IIIrd nerve damage, viz. variable IIIrd nerve innervated muscle involvement and signs of misdirection regeneration. The palsy may be isolated or associated with additional perinatal neurologic damage (Fig. 83.1).2

B. With features suggesting a primary nuclear maldevelopment, viz. bilateral partial ptosis and contralateral superior rectus palsy. A hypoplastic peripheral IIIrd nerve may be seen on MR imaging and specific genetic mutations known to be associated with CCDD identified.

C. Unilateral congenital IIIrd nerve palsy has also been reported in:

D. Variants:

Acquired IIIrd nerve palsy

Most cases are unilateral and likely to occur in a clinical context that helps establish the etiology.2

Rare causes

IVth nerve palsy

Congenital palsy

This is the commonest congenital cranial nerve palsy and the commonest cause of hypertropia in children.7 It is usually unilateral.

The clinical signs are:

Jun 4, 2016 | Posted by in OPHTHALMOLOGY | Comments Off on Cranial nerve and eye muscle palsies

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