Isolated superior division oculomotor palsy in a child with spontaneous recovery

Saeki, Naokatsu; Yotsukura, Jiro; Adachi, Eri; Yamaura, Akira

doi:10.1054/jocn.1998.0152

Cited by 9 publications

(8 citation statements)

References 7 publications

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“…[10][11][12] One of these cases reported by Engelhardt, 5-year-old boy had superior division palsy just after a common cold. Increased titers of the influenza-A virus have been detected in the serological tests in this case and symptoms resolved spontaneously after four months follow-up.…”

Section: Discussionmentioning

confidence: 99%

Management of a Case with Isolated Oculomotor Nerve Palsy

Gök¹,

Aslan²,

Altıntaş³

2019

Turkiye Klinikleri J Ophthalmol

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he oculomotor nerve is divided into superior and inferior divisions in the region of the anterior cavernous sinus and superior orbital fissure. The superior division oculomotor palsy is usually seen in spheno-cavernous region or orbital apex. Oculomotor superior division innervates levator palpebrae superioris and superior rectus muscles. Therefore, mild ptosis and upgaze restriction could be seen in patients with superior division palsy, besides pupillary reactions have been preserved. 1 1 1 Management of a Case With IsolatedOculomotor Nerve Palsy A AB BS ST TR RA AC CT T The oculomotor nerve has a divisional topographic arrangement at the brain stem and extends with fascicular, cisternal, cavernous sinus and orbital portions. The lesions, at any site along this course, can cause nerve paralysis and the etiologies may differ in adult and child age groups. Congenital reasons, craniopharyngioma, trauma, inflammatory and infectious causes, ophthalmoplegic migraine, malignancy (lymphoma, leukemia), cranial aneurysms are the possible underlying diagnoses in the childhood. The most of the divisional oculomotor nerve palsy reports in the literature are linked to post-viral etiology in the child age group. The current clinical picture resolved spontaneously in these cases. We presented a case of an 8-year-old girl with left eye superior division oculomotor palsy. The clinical investigations for clarifying underlying causes were unremarkable. After a certain follow-up period for spontaneous resolution, surgical treatment was performed and this case is the first one who treated successfully with surgery in the child age group.K Ke ey yw wo or rd ds s: : Oculomotor nerve; child; surgery Ö ÖZ ZE ET T Okülomotor sinir, beyin sapında topografik olarak fasiküler, sisternal, kavernöz sinüs ve orbital dallara ayrılacak şekilde düzenlenmiştir. Kafa içinde, belirtilen bu dalların seyri boyunca herhangi bir yerdeki lezyonlar sinir felcine neden olabilir ve etiyolojik sebepler yetişkin ve çocuk yaş gruplarında farklılık gösterebilir. Konjenital nedenler, kraniyofarenjiyoma, travma, inflamatuvar ve enfeksiyöz nedenler, oftalmoplejik migren, malignite (lenfoma, lösemi), kraniyal anevrizmalar çocuk yaş grubundaki olası sebeplerdir. Literatürde çocuk yaş grubundaki okülomotor sinir dal felci vakalarının çoğu post-viral sebeplerle ilişkilendirilmiştir. Takiplerde bu olgularda mevcut klinik tablo kendiliğinden düzelmiştir. Bu vaka sunumu sol göz okulomotor sinir üst dal felci bulunan 8 yaşında bir kız çocuğuna ait idi. Altta yatan muhtemel nedenlerin araştırıldığı muayene ve tetkiklerde herhangi bir patoloji saptanmadı. Literatürdeki diğer vakalar dikkate alındığında hernekadar klinik araştırmalarda bir patoloji saptanmasa da spontan düzelme için hasta belli bir süre takip edildi. Fakat klinik bulgularında düzelme olmayan hastaya cerrahi tedavi uygulandı. Bu vaka literatürde çocuk yaş grubunda cerrahi ile başarılı şekilde tedavi edilen okulomotor sinir dal felci olan ilk çocuk hastadır.A An na ah ht ta ar r K Ke el li im me el le er r: :...

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Section: Discussionmentioning

confidence: 99%

Management of a Case with Isolated Oculomotor Nerve Palsy

Gök¹,

Aslan²,

Altıntaş³

2019

Turkiye Klinikleri J Ophthalmol

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“…In adults, common causes of oculomotor nerve palsy are aneurysms, trauma, diabetes mellitus, and neoplasms. The relevant neoplasms are mostly pituitary adenomas and metastatic tumors [ 4 ]. The prognosis of oculomotor nerve palsy varies according to its etiology and associated cranial nerve problems.…”

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confidence: 99%

“…The prognosis of oculomotor nerve palsy varies according to its etiology and associated cranial nerve problems. In children, common causes are congenital factors, trauma, inflammation, neoplasms, aneurysms, and others [ 4 ]. The exact pathophysiology of oculomotor palsy is not well understood.…”

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confidence: 99%

“…Direct injury or indirect compression can also result in palsy. If the cause is inflammation, postinfectious neuropathy may affect the nerve, but this mechanism of pathogenesis is not well understood [ 4 ]. Clinically, pupillary function shows great variability.…”

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confidence: 99%

“…Oculomotor nerve palsy that presents with smaller pupils may be due to Horner's syndrome or diabetic autonomic neuropathy. Partial oculomotor nerve palsy can resolve in one to three months [ 4 ]. The improvement of visual acuity has been known to be difficult to achieve [ 2 ].…”

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Traumatic Oculomotor Nerve Palsy

et al. 2015

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Superior Divisional Third Cranial Nerve Paresis

Bhatti¹,

Eisenschenk²,

Roper³

et al. 2006

Arch Neurol

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Background: Within the midbrain, the third nerve nucleus is composed of a complex of subnuclei. The fascicular portion of the nerve courses through the red nucleus and exists in the midbrain just medial to the cerebral peduncle. The cisternal portion of the nerve is a single structure that divides into a superior branch and an inferior branch in the region of the cavernous sinus and superior orbital fissure.Objective: To describe 2 patients with superior divisional third cranial nerve paresis resulting from a lesion involving the cisternal portion of the nerve prior to its anatomical bifurcation.Patients: Case 1 was a 77-year-old man with a superior divisional third nerve palsy as the presenting manifestation of a posterior communicating artery aneu-rysm. Case 2 was a 41-year-old woman who developed a superior divisional third nerve palsy following anterior temporal lobectomy for epilepsy. Results:In both cases, the presumed location of the lesion was the cisternal portion of the third cranial nerve.Conclusions: Although the anatomical division of the third cranial nerve occurs in the region of the anterior cavernous sinus or superior orbital fissure, there is a topographical arrangement of the motor fibers within the cisternal portion of the nerve. The clinical evaluation of a patient with a third cranial nerve paresis requires an understanding of the regional neuroanatomy and topographical organization of the nerve.

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Isolated superior division oculomotor palsy in a child with spontaneous recovery

Cited by 9 publications

References 7 publications

Management of a Case with Isolated Oculomotor Nerve Palsy

Management of a Case with Isolated Oculomotor Nerve Palsy

Traumatic Oculomotor Nerve Palsy

Superior Divisional Third Cranial Nerve Paresis

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