VOLUME 5, NUMBER 36 |
November 28, 2016 |
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Third nerve palsies can be alarming, because the diagnosis may potentially point to an aneurysm or a space–occupying mass. When should I be concerned? |
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A third nerve palsy typically presents with a ptosis and diplopia (upon eyelid lifting) secondary to motility restriction, as well as limited elevation. The underlying cause often may be differentiated by pupillary appearance. Generally speaking, if the pupil is dilated, you likely should consider the existence of more serious neurological conditions, such as a space–occupying lesion or an aneurysm. More specifically, a third nerve palsy with a blown pupil, combined with a significant headache, requires prompt referral to a neurologist/neurosurgeon for an imaging study.
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"Success is the sum of small efforts – repeated day in and day out" |
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