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ALL / Neurology
Third nerve palsy
Third nerve palsy
Features- eye is deviated 'down and out'
- ptosis
- pupil may be dilated (sometimes called a 'surgical' third nerve palsy)
Causes
- diabetes mellitus
- vasculitis e.g. temporal arteritis, SLE
- false localizing sign* due to uncal herniation through tentorium if raised ICP
- posterior communicating artery aneurysm
- pupil dilated
- often associated pain
- cavernous sinus thrombosis
- Weber's syndrome: ipsilateral third nerve palsy with contralateral hemiplegia -caused by midbrain strokes
- other possible causes: amyloid, multiple sclerosis
*this term is usually associated with sixth nerve palsies but it may be used for a variety of neurological presentations
+PassMedicine Notes
Features
- eye is deviated 'down and out'
- ptosis
- pupil may be dilated (sometimes called a 'surgical' third nerve palsy)
- diabetes mellitus
- vasculitis e.g. temporal arteritis, SLE
- false localizing sign* due to uncal herniation through tentorium if raised ICP
- posterior communicating artery aneurysm
- pupil dilated
- often associated pain
- cavernous sinus thrombosis
- Weber's syndrome: ipsilateral third nerve palsy with contralateral hemiplegia -caused by midbrain strokes
- other possible causes: amyloid, multiple sclerosis
*this term is usually associated with sixth nerve palsies but it may be used for a variety of neurological presentations
