Idiopathic unilateral oculomotor nerve palsy: A case report

Abstract

Cranial nerve III palsy, also known as oculomotor nerve palsy, may result from various causes; however, the etiology remains unknown in some instances. The aim of this case report is to present the authors' experience with two cases of idiopathic cranial nerve III palsy, together with a review of the literature. Case 1 is a 78-year-old woman and case 2 is a 75-year-old man, both having no history of trauma and no vascular risk factors. They presented to the authors' hospital with diplopia and palpebral ptosis and were diagnosed with idiopathic unilateral cranial nerve III palsy. They received oral steroids for treatment. One patient recovered completely within 3 months, while the other patient did not recover regardless of long-term follow-up. Idiopathic cranial nerve III palsy can occur in otherwise healthy individuals and often recover in several months. Careful examinations to rule out other causes and then steroid treatment should be considered after early diagnosis.

Idiopathic unilateral third nerve palsy with pupillary sparring in 10-year-old child -a case report

“…Nerve palsies less frequently occur in children with an incidence rate of 7.6 per 10, 00 000 [ 3 ]. Idiopathic causes of unilateral nerve palsy remain unsolved, accounting for 12–14% of cases in children [ 4 , 5 ] despite recent breakthroughs in imaging and laboratory procedures. Congenital and acquired causes are involved.…”

Unilateral Oculomotor Nerve Palsy Associated With Primary Hypothyroidism: Two Case Reports

“…For hypothyroidism-associated oculomotor neuritis, as mentioned in the literatures [4,18], is characterized by an enhanced oculomotor nerve signals seen on cranial MRI. In treatment, highdose steroid hormone therapy will show good results [19,14,15,20,21]. Importantly the symptoms are not correlation with a decrease of thyroid hormones [4].…”

“…Patients with idiopathic ophthalmic nerve palsy, as reported in other clinics, have responded well to steroids [7], but the mechanism is unclear; indeed, there is no clear evidence in this report to support a clear relationship between treatment outcome and glucocorticoids. This kind of oculomotor nerve palsy has been reported to occur in an idiopathic manner in healthy adults but can often resolve within a few months [18][19][20][21].…”

“…Oculomotor nerve palsy can result from a variety of causes, including microvascular dysfunction, aneurysm compression, stroke, trauma, tumor compression, neurosurgery, and other causes, however, due to primary hypothyroidism has rarely been reported [1,2,3,20].…”

“…The most common symptoms in adults are fatigue, lethargy, cold intolerance, weight gain, constipation, change in voice, and dry skin, but clinical presentation can differ with age and sex among other factors. Although ocular symptoms are additionally appeared in many patients, expressing as periorbital puffiness [1,3,8,11,12,14,20,21]. To our knowledge, only a few reports have been associated with "idiopathic" oculomotor nerve palsy [6,7].…”