Congenital Oculomotor Nerve Paresis With Isolated Cyclic Pupillary Spasms

Salman, Michael S.; Klassen, Samantha F.; Clark, Ian

doi:10.1097/wno.0000000000000285

Cited by 10 publications

(5 citation statements)

References 9 publications

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“…Levator shortening and lid suspension can assist with the ptosis but must be carefully weighed with the risk of corneal exposure [1,4]. Currently, no treatment has been proven to have an effect on cyclic spasms [5].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Asymmetrical Cyclic Oculomotor Palsy with Spasm – A Case Report

Mishan,

Davidovici

2023

Series Clin Med Case Rep Rev

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This is a unique case of bilateral asymmetrical cyclic oculomotor palsy with spasm (COPS). This is an unusual presentation of COPS, which is usually unilateral. The patient initially presented with cyclic upper lid ptosis, exotropia, hypotropia, and mydriasis, lasting approximately 1.5 minutes. The affected eye would then recover, and the other eye would undergo the same pattern of symptoms in keeping with COPS. The right eye has shown spontaneous improvement of symptoms over the 7 years of follow-up. The use of ptosis surgery, together with patching, seems to have been able to prevent the development of amblyopia in the left, worse-affected eye.

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Section: Discussionmentioning

confidence: 99%

Bilateral Asymmetrical Cyclic Oculomotor Palsy with Spasm – A Case Report

Mishan,

Davidovici

2023

Series Clin Med Case Rep Rev

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“…The history and examination findings in Case 4 helped make the diagnosis of oculomotor nerve paresis with cyclic spasm, which is a rare congenital condition that is usually not associated with tumors, except in rare cases of a glioma (16). Therefore, neuroimaging studies are usually normal.…”

Section: Case 5: Radiation-induced Cn III Palsy With Neuromyotoniamentioning

confidence: 99%

Oculomotor Nerve Palsy Due to Unusual Causes

Tian

Kardon

Feng

et al. 2020

Journal of Neuro-Ophthalmology

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Background: An isolated oculomotor nerve (CN III) palsy is a diagnostic concern because of the potential for serious morbidity or life-threatening causes. We present 5 unusual causes of oculomotor nerve palsy that escaped initial diagnosis in order to raise awareness of their associated features that will facilitate correct diagnosis. Methods: This study consisted of a retrospective analysis of clinical features and imaging of 5 patients who were referred for neuro-ophthalmologic evaluation with presumed diagnosis of oculomotor nerve palsy of unknown reasons.Results: A complete CN III palsy and an inferior division CN III palsy were diagnosed with a schwannoma in the cavernous sinus and orbital apex portion, respectively; a middle-aged woman with aberrant regeneration was found to have a small meningioma; an adult man with ptosis was diagnosed with cyclic oculomotor paresis with spasms; and a patient after radiation was diagnosed with neuromyotonia. Conclusions: Localizing the lesion of oculomotor nerve palsy and careful examination of the imaging is crucial. Aberrant regeneration, cyclic pupil changes, and past medical history of amblyopia, strabismus, or radiation are also very helpful for diagnosis.

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“…During the spastic phase, the pupil undergoes miosis, lid elevation, and esotropia, whereas during paralysis, the pupil undergoes mydriasis, ptosis, and exotropia. Isolated cyclic pupillary spasms have only been reported by Salman et al (3) in a child with congenital oculomotor nerve paresis. In this article, we report the case of an adult presenting with oculomotor nerve paresis with mainly pupillary cyclic spasms without any changes in the eyelid or cyclic eye movement.…”

mentioning

confidence: 93%

“…To the best of our knowledge, isolated cyclic pupillary spasms have previously been reported in only 1 case of an 18-month-old girl, in whom congenital oculomotor nerve paresis was diagnosed when she was age 4 months (3). Although our patient was an adult, a review of her family photograph album revealed ptosis in her right eye when she was age 3 years (see Supplemental Digital Content , Supplemental Material 2 , http://links.lww.com/WNO/A657).…”

mentioning

confidence: 94%