Acute Neurological Conditions with Ocular Presentations

Question 1

What is a Painful third nerve palsy?

Answer 1

Extraocular muscle paralysis due to lesions in the Oculomotor Nerve resulting in failure to rotate the eyes

Question 2

Which muscles does a third nerve palsy affect?

Answer 2

All extraocular except Superior Oblique and Lateral Rectus

Question 3

Is there ptosis in third nerve palsy?

Answer 3

Yes FULL PTOSIS because the Oculomotor nerve innervates the Levator Palpebrae muscle

Question 4

Is there Miosis in Third Nerve palsy?

Answer 4

Yes because the Oculomotor nerve innervates the Ciliary Muscle and Iris Sphincter

Question 5

What causes a Third Nerve Palsy?

Answer 5

Trauma, Berry aneurysm, Infection, Inflammation

Question 6

What is the treatment of a Third Nerve Palsy? (3)

Answer 6

Treat the cause, NSAIDs, most spontaneously recover in 6 weeks

Question 7

What is Painful Horner’s Syndrome?

Answer 7

Miosis, Partial Ptosis, Anhydrosis of one eye caused by interruption of the sympathetic chain to the eye

Question 8

What causes Horner’s Syndrome?

Answer 8

Lesion of primary neuron, brainstem stroke, Lung tumour

Question 9

What is the treatment for Horner’s Syndrome?

Answer 9

Treat the cause