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Photo essay. Isolated fascicular third nerve palsy.

Authors
  • Purvin, Valerie
Type
Published Article
Journal
Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society
Publication Date
Sep 01, 2010
Volume
30
Issue
3
Pages
263–265
Identifiers
DOI: 10.1097/WNO.0b013e3181ebb996
PMID: 20724943
Source
Medline
License
Unknown

Abstract

A 72-year-old hypertensive woman developed acute diplopia and right upper lid ptosis. Examination showed a partial right third nerve palsy with complete ptosis, moderately impaired adduction and supraduction, and sparing of infraduction and the pupil. There were no other neurologic deficits. Brain MRI with diffusion weighting demonstrated an infarct in the right paramedian midbrain tegmentum along the course of the third nerve fascicles. The clinical deficit and neuroimaging in this case provide further support for a previously suggested topographic organization of the fascicles of the third nerve within the brainstem.

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