Oculomotor Nerve Palsy - Cause - Acquired Oculomotor Palsy

Acquired Oculomotor Palsy

  • 1. Vascular disorders such as diabetes, heart disease, atherosclerosis and aneurysm, particularly of the posterior communicating artery
  • 2. Space occupying lesions or tumours, both malignant and non-malignant
  • 3. Inflammation and Infection
  • 4. Trauma
  • 5. Demyelinating disease (Multiple sclerosis)
  • 6. Autoimmune disorders such as Myasthenia gravis
  • 7. Post operatively as a complication of neurosurgery
  • 8. Cavernous sinus thrombosis

Ischemic insult selectively affects somatic fibers over parasympathetic fibers, while traumatic insult affects both types more equally. Therefore, while almost all forms cause ptosis and impaired movement of the eye, pupillary abnormalities are more commonly associated with trauma than with ischemia.

Oculomotor palsy can be of acute onset over hours with symptoms of headache when associated with diabetes Mellitus. Diabetetic neuropathy of the oculomotor nerve in a majority of cases does not effect the pupil<1> . The sparing of the pupil is thought to be associated with the microfasciculation of the edge fibers which control the pupillomotor fibers, which control the pupil. <2>

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