Evaluation of Third Nerve Palsy in the Emergency Department

Journal of Emergency Medicine

Volumn 35, Issue 3, 2008, Pages 239-246

  Woodruff, Michael M ^a   Edlow, Jonathan A ^a  

^a BETH ISRAEL DEACONESS MEDICAL CENTER   (United States)

Author keywords

cranial neuropathy; dilatated pupil; emergency medicine; third nerve palsy

Indexed keywords

ADULT; ARTICLE; BRAIN STEM; CASE REPORT; CAVERNOUS SINUS; CLINICAL FEATURE; EMERGENCY WARD; HUMAN; MAGNETIC RESONANCE ANGIOGRAPHY; MALE; MESENCEPHALON; MYDRIASIS; NERVE PARALYSIS; NUCLEAR MAGNETIC RESONANCE IMAGING; OCULOMOTOR NERVE DISEASE; ORBIT; PRIORITY JOURNAL; SLIT LAMP; SUBARACHNOID SPACE; VISUAL ACUITY;

DILATATION, PATHOLOGIC; EMERGENCY SERVICE, HOSPITAL; HUMANS; INTRACRANIAL ANEURYSM; MAGNETIC RESONANCE IMAGING; MALE; MIDDLE AGED; OCULOMOTOR MUSCLES; OCULOMOTOR NERVE DISEASES; PHYSICAL EXAMINATION; PUPIL;

EID: 52049112780     PISSN: 07364679     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jemermed.2007.04.020     Document Type: Article

References (46)

1. Green W.R., Hackett E.R., and Schlezinger N.S. Neuro-ophthalmologic evaluation of oculomotor nerve paralysis. Arch Ophthalmol 72 (1964) 154-167
2. Kissel J.T., Burde R.M., Klingele T.G., and Zeiger H.E. Pupil-sparing oculomotor palsies with internal carotid-posterior communicating artery aneurysms. Ann Neurol 13 (1983) 149-154
3. Biousse V., and Newman N.J. Third nerve palsies. Semin Neurol 20 (2000) 55-74
4. Scherer K., Bedlack R.S., and Simel D.L. Does this patient have myasthenia gravis?. JAMA 293 (2005) 1906-1914
5. Finsterer J. Ptosis: causes, presentation, and management. Aesthetic Plast Surg 27 (2003) 193-204
6. Lee A.G., Hayman L.A., and Brazis P.W. The evaluation of isolated third nerve palsy revisited: an update on the evolving role of magnetic resonance, computed tomography, and catheter angiography. Surv Ophthalmol 47 (2002) 137-157
7. Lee A.G., Taber K.H., Hayman L.A., and Tang R.A. A guide to the isolated dilated pupil. Arch Fam Med 6 (1997) 385-388
8. Thompson S., and Pilley S.F. Unequal pupils. A flow chart for sorting out the anisocorias. Surv Ophthalmol 21 (1976) 45-48
9. Lam B.L., Thompson H.S., and Corbett J.J. The prevalence of simple anisocoria. Am J Ophthalmol 104 (1987) 69-73
10. Anastasi L.M., Ogle K.N., and Kearns T.P. Effect of pilocarpine in counteracting mydriasis. Arch Ophthalmol 79 (1968) 710-715
11. Bourgon P., Pilley F.J., and Thompson H.S. Cholinergic supersensitivity of the iris sphincter in Adie's tonic pupil. Am J Ophthalmol 85 (1978) 373-377
12. Miller M.J., Mark L.P., Ho K.C., and Haughton V.M. Anatomic relationship of the oculomotor nuclear complex and medial longitudinal fasciculus in the midbrain. AJNR Am J Neuroradiol 18 (1997) 111-113
13. Porter J.D., Guthrie B.L., and Sparks D.L. Innervation of monkey extraocular muscles: localization of sensory and motor neurons by retrograde transport of horseradish peroxidase. J Comp Neurol 218 (1983) 208-219
14. Keane J.R. Isolated brain-stem third nerve palsy. Arch Neurol 45 (1988) 813-814
15. Mark A.S. Oculomotor motion disorders: current imaging of cranial nerves 3, 4, and 6. Semin Ultrasound CT MR 19 (1998) 240-256
16. Liu G.T., Crenner C.W., Logigian E.L., Charness M.E., and Samuels M.A. Midbrain syndromes of Benedikt, Claude, and Nothnagel: setting the record straight. Neurology 42 (1992) 1820-1822
17. Biller J., Shapiro R., Evans L.S., Haag J.R., and Fine M. Oculomotor nuclear complex infarction. Clinical and radiological correlation. Arch Neurol 41 (1984) 985-987
18. Keane J.R., Zaias B., and Itabashi H.H. Levator-sparing oculomotor nerve palsy caused by a solitary midbrain metastasis. Arch Neurol 41 (1984) 210-212
19. Stevenson G.C., and Hoyt W.F. Metastasis to midbrain from mammary carcinoma. Cause of bilateral ptosis and ophthalmoplegia. JAMA 186 (1963) 514-516
20. Harris F.S., and Rhoton A.L. Anatomy of the cavernous sinus. A microsurgical study. J Neurosurg 45 (1976) 169-180
21. Morard M.V., Tcherekayev V., and de Tribolet N. The superior orbital fissure: a microanatomical study. Neurosurgery 35 (1994) 1087-1093
22. Yeh S., and Foroozan R. Orbital apex syndrome. Curr Opin Ophthalmol 15 (2004) 490-498
23. Wiebers D.O., Whisnant J.P., Huston III J., et al. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet 362 (2003) 103-110
24. Kassell N.F., Torner J.C., Haley Jr. E.C., Jane J.A., Adams H.P., and Kongable G.L. The International Cooperative Study on the Timing of Aneurysm Surgery. Part 1: overall management results. J Neurosurg 73 (1990) 18-36
25. Kassell N.F., Torner J.C., Jane J.A., Haley Jr. E.C., and Adams H.P. The International Cooperative Study on the Timing of Aneurysm Surgery. Part 2: surgical results. J Neurosurg 73 (1990) 37-47
26. Rabinstein A.A., Weigand S., Atkinson J.L., and Wijdicks E.F. Patterns of cerebral infarction in aneurysmal subarachnoid hemorrhage. Stroke 36 (2005) 992-997
27. Parra A., Kreiter K.T., Williams S., et al. Effect of prior statin use on functional outcome and delayed vasospasm after acute aneurysmal subarachnoid hemorrhage: a matched controlled cohort study. Neurosurgery 56 (2005) 476-484
28. Wardlaw J.M., and White P.M. The detection and management of unruptured intracranial aneurysms. Brain 123 (2000) 205-221
29. Richards B.W., Jones Jr. F.R., and Younge B.R. Causes and prognosis in 4,278 cases of paralysis of the oculomotor, trochlear, and abducens cranial nerves. Am J Ophthalmol 113 (1992) 489-496
30. Rucker C.W. The causes of paralysis of the third, fourth and sixth cranial nerves. Am J Ophthalmol 61 (1966) 1293-1298
31. Rucker C.W. Paralysis of the third, fourth and sixth cranial nerves. Am J Ophthalmol 46 (1958) 787-794
32. Kerr W.L., and Hollowell O.W. Location of pupillomotor and accommodation fibres in the oculomotor nerve: experimental observations on paralytic mydriasis. J Neurol Neurosurg Psychiatry 27 (1964) 473-481
33. Trobe J.D. Third nerve palsy and the pupil. Footnotes to the rule. Arch Ophthalmol 106 (1988) 601-602
34. Goldstein J.E., and Cogan D.G. Diabetic ophthalmoplegia with special reference to the pupil. Arch Ophthalmol 64 (1960) 592-600
35. Asbury A.K., Aldredge H., Hershberg R., and Fisher C.M. Oculomotor palsy in diabetes mellitus: a clinico-pathological study. Brain 93 (1970) 555-566
36. Said G., Goulon-Goeau C., Lacroix C., and Moulonguet A. Nerve biopsy findings in different patterns of proximal diabetic neuropathy. Ann Neurol 35 (1994) 559-569
37. Lustbader J.M., and Miller N.R. Painless, pupil-sparing but otherwise complete oculomotor nerve paresis caused by basilar artery aneurysm. Case report. Arch Ophthalmol 106 (1988) 583-584
38. Ajtai B., Fine E.J., and Lincoff N. Pupil-sparing, painless compression of the oculomotor nerve by expanding basilar artery aneurysm: a case of ocular pseudomyasthenia. Arch Neurol 61 (2004) 1448-1450
39. Bartleson J.D., Trautmann J.C., and Sundt Jr. T.M. Minimal oculomotor nerve paresis secondary to unruptured intracranial aneurysm. Arch Neurol 43 (1986) 1015-1020
40. Kasoff I., and Kelly Jr. D.L. Pupillary sparing in oculomotor palsy from internal carotid aneurysm. Case report. J Neurosurg 42 (1975) 713-717
41. Guy J., Savino P.J., Schatz N.J., Cobbs W.H., and Day A.L. Superior division paresis of the oculomotor nerve. Ophthalmology 92 (1985) 777-784
42. Huston III J., Nichols D.A., Luetmer P.H., et al. Blinded prospective evaluation of sensitivity of MR angiography to known intracranial aneurysms: importance of aneurysm size. AJNR Am J Neuroradiol 15 (1994) 1607-1614
43. Chung T.S., Joo J.Y., Lee S.K., Chien D., and Laub G. Evaluation of cerebral aneurysms with high-resolution MR angiography using a section-interpolation technique: correlation with digital subtraction angiography. AJNR Am J Neuroradiol 20 (1999) 229-235
44. Villablanca J.P., Jahan R., Hooshi P., et al. Detection and characterization of very small cerebral aneurysms by using 2D and 3D helical CT angiography. AJNR Am J Neuroradiol 23 (2002) 1187-1198
45. Anderson G.B., Steinke D.E., Petruk K.C., Ashforth R., and Findlay J.M. Computed tomographic angiography versus digital subtraction angiography for the diagnosis and early treatment of ruptured intracranial aneurysms. Neurosurgery 45 (1999) 1315-1320 discussion 1320-2
46. Johnson M.R., Good C.D., Penny W.D., Barnes P.R., and Scadding J.W. Lesson of the week: playing the odds in clinical decision making: lessons from berry aneurysms undetected by magnetic resonance angiography. BMJ 322 (2001) 1347-1349