3rd Nerve Palsy

Question 1

Signs

Answer 1

Ptosis
Unreactive dilated pupil to direct and consensual light
Unreactive to accom
Divergent strabismus at rest->Eye is down and out
Angulated diplopia-> superior gaze
Always exclude 4th nerve

Question 2

Causes

Answer 2

Central:

Idiopathic
Tumour
Vascular event
Demyelination 
Trauma

Peripheral:

Compressive: PCOM aneurysm, nasopharyngeal ca, orbital lesions, basal meningitis, tumour causing raised ICP ( dilated pupil early)
Infection: EBV
Infarction: arthritis, DM (pupil sparing)
Trauma
Cavernous sinus lesions