J Korean Ophthalmol Soc.  2021 Oct;62(10):1420-1427. 10.3341/jkos.2021.62.10.1420.

Analysis of Early Neuroimaging Results in Patients with Acute Isolated Ocular Motor Nerve Palsy

• Jeong DE
• Kim DH

• KMID: 2521645
• DOI: http://doi.org/10.3341/jkos.2021.62.10.1420

Abstract

Purpose
To evaluate the efficacy of early neuroimaging in patients with acute isolated 3rd, 4th, and 6th nerve palsy.
Methods
Neuroimaging tests were performed in patients >50 years old with acute isolated 3rd, 4th, and 6th nerve palsy. The frequencies and types of abnormal findings were evaluated. All patients were divided into ischemic and non-ischemic groups and differences in clinical characteristics between groups were analyzed.
Results
Of the 55 patients, nine (16.4%) had abnormal findings on brain imaging. Among 26 patients with 6th nerve palsy, four (15.4%) were found to have a cause including brain tumor, cerebrovascular compression, carotid cavernous fistula. Superior oblique muscle atrophy was found in two of 19 patients (10.5%) with 4th nerve palsy. Three of 10 patients (30%) with 3rd nerve palsy had abnormal findings and there were cases of pituitary apoplexy, posterior communicating, and cerebrovascular compression.
Conclusions
In patients with acute isolated oculomotor paralysis, early neuroimaging tests play an important role in differential diagnosis and evaluation of causes that may lead to mortality.

Keyword

Cranial nerve diseases, Isolated, Magnetic resonance imaging, Neuroimaging