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What are the signs of oculomotor nerve damage?

By Daniel Moore

What are the signs of oculomotor nerve damage?

Third cranial nerve disorders can impair ocular motility, pupillary function, or both. Symptoms and signs include diplopia, ptosis, and paresis of eye adduction and of upward and downward gaze. If the pupil is affected, it is dilated, and light reflexes are impaired.

What is the treatment for third nerve palsy?

Unfortunately, there is no treatment to re-establish function of the weak nerve if it is a congenital case. An acquired third nerve palsy may resolve, depending on the cause. Relief of pressure on the third nerve from a tumor or blood vessel (aneurysm) with surgery may improve the third nerve palsy.

What will happen when the oculomotor nerve is damaged?

Damage to any of these nerves or the muscle or muscles they innervate causes dysconjugate gaze, which results in characteristic patterns of diplopia (double vision). In addition, with oculomotor nerve damage, patients also lose their pupillary constriction to light as well as the elevation of their eyelid.

What is pupil sparing?

Pupil-sparing oculomotor nerve palsy is often assumed to be caused by ischemic injury such as hypertension and diabetes mellitus. Sometimes compressive lesion can cause pupil-sparing oculomotor nerve palsy with a short interval from the onset of symptoms to diagnosis.

Is third nerve palsy a stroke?

An isolated third nerve palsy is a rare presentation of stroke. Historical features and risk factors can help distinguish the cause of third nerve palsy. A detailed neurological examination with attention to ‘neighboring’ signs is essential during the evaluation of individuals presenting with third nerve palsy.

What does oculomotor nerve do?

The oculomotor nerve is the third cranial nerve (CN III). It allows movement of the eye muscles, constriction of the pupil, focusing the eyes and the position of the upper eyelid. Cranial nerve III works with other cranial nerves to control eye movements and support sensory functioning.

What muscles are controlled by the oculomotor nerve?

The oculomotor nerve controls several muscles:

  • Levator palpebrae superioris – raises the upper eyelid.
  • Superior rectus muscle – rotates the eyeball backward, “looking up”
  • Medial rectus muscle – adducts the eye, “looking towards your nose”
  • Inferior rectus muscle – rotates the eyeball forwards, “looking down”

What is pupil sparing 3rd nerve palsy?

Pupil: In compressive third-nerve palsy, the pupil becomes fixed and dilated due to paralysis of sphincter pupillae. Ciliary muscle paralysis also leads to loss of accommodation. However, in ischemic lesions, the pupil is spared, and there is no loss of accommodation.

What is sixth nerve palsy?

Sixth nerve palsy occurs when the sixth cranial nerve is damaged or doesn’t work right. It’s also known as the abducens nerve. This condition causes problems with eye movement. The sixth cranial nerve sends signals to your lateral rectus muscle. This is a small muscle that attaches to the outer side of your eye.

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