Oculomotor nerve palsies involving only the internal eye muscles are extremely rare. The authors report a 33-year-old female who presented with isolated pupillary and ciliary dysfunction that eventually turned into a typical third nerve palsy. In I 979 she developed a tonically dilated pupil with preserved, but reduced accommodation. In I 993 she began to develop diplopia on eccentric gaze direction. The pupil had become dilated and completely immobile and the ciliary muscle was paralytic. Eye motility abnormalities were consistent with a mild third nerve paresis and there was an elevation of the upper eyelid on adduction (primary misdirected regeneration). MRI revealed a parasellar mass lesion, probably a neurinoma, arising from the right oculomotor nerve. The authors decided not to treat this slowly growing tumor. Phone 49707 I 294786 Fax 497071 295038 Oral Presentation at the Meeting of the International Neuro-ophthalmological Society. June 5 -9~ "394 in Freiburg/Gemany Key words tor nerve; cranial nerves; primary aberrant regeneration Third nerve palsy; pupil; tonic pupil; tumor of the oculomo-Oculomotor nerve paresis starting as isolated internal ophthalmoplegia 2 I I Neuroophthalmology Downloaded from informahealthcare.com by McMaster University on 01/05/15 For personal use only.
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