Giant cell arteritis presenting as oculomotor nerve palsy with pupillary dilatation

Davies, Gillian; Shakir, Raad

doi:10.1136/pgmj.70.822.298

Cited by 26 publications

(11 citation statements)

References 2 publications

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“…In a retrospective review of 34 consecutive cases of isolated atraumatic third nerve palsies, diabetes mellitus was the most common etiology accounting for 46% of the cases. 50 Ischemic third nerve palsy may also occur with giant cell arteritis 50,51 and systemic lupus erythematosus. Pupil-sparing third nerve palsy has also been reported with sildenafil citrate (Viagra 1 ; Pfizer Pharmaceuticals, New York, NY) 52 and cocaine use.…”

Section: Isolated Third Nerve Palsy Due To An Orbital Lesionmentioning

confidence: 99%

Isolated Palsies of Cranial Nerves III, IV, and VI

Brazis

2009

Semin Neurol

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In this article, isolated palsies of cranial nerves III, IV, and VI are addressed. After discussion of the pertinent clinical anatomy of cranial nerves III, IV, and VI, the isolated involvement of each of these oculomotor nerves is defined. Based on a review of the literature, methods of evaluation and follow-up of patients presenting with diplopia from lesions of these cranial nerves are presented.

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Section: Isolated Third Nerve Palsy Due To An Orbital Lesionmentioning

confidence: 99%

Isolated Palsies of Cranial Nerves III, IV, and VI

Brazis

2009

Semin Neurol

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“…Cranial nerve palsies are well recognised as complications of GCA but these most commonly affect the nerves responsible for eye movements with third and sixth nerve palsies most commonly reported [11][12][13][14][15][16][17][18][19][20][21][22][23]. A good response to steroids is usually providing the diagnosis is made promptly.…”

Section: Discussionmentioning

confidence: 99%

Patient-reported involvement of the eighth cranial nerve in giant cell arteritis

et al. 2019

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Introduction The frequency of eighth nerve lesions in patients with giant cell arteritis (GCA) has rarely been examined. However, sudden onset deafness has been recorded as a presenting feature of GCA on several occasions. This study sought to establish how common this and other symptoms of eighth nerve involvement are in a large retrospective survey. Methods We contacted 170 patients with GCA and 250 matched PMR patients, inviting them to participate in a questionnaire survey of symptoms of eighth nerve dysfunction. We compared the presence of deafness, tinnitus, loss of balance and vertigo in both groups and examined the relationship between the onset of these symptoms and other features of GCA. Results A total of 317 patients were recruited. The percentage of patients with symptoms of possible vestibulocochlear disease prior to commencement of steroid therapy was significantly greater among GCA patients than PMR patients for all domains. Hearing loss which was twice as common in GCA as in PMR (53% vs 26%) [p = 0.001]. Deafness was concurrent in 35% of GCA patients with other symptoms and 45% reported colocation with headache. Recovery with steroids occurred in 56% of these. Conclusion Symptoms of eighth nerve dysfunction are present in over half of patients with GCA. Recovery with steroids was predicted by concurrence with headache in terms of both timing and location. It appears that eighth nerve involvement, especially acute hearing loss, is a not infrequent feature of GCA and often responds well to steroid therapy. Clinicians should enquire about these symptoms when evaluating a patient for possible GCA. Key Points • Deafness is a frequent presenting feature of giant cell arteritis. • Vertigo, tinnitus and loss of balance are also often reported by GCA sufferers. • Steroid therapy is more likely to relieve these symptoms if they are ipsilateral and concurrent with headache.

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“…Variadas hipótesis se han postulado para explicar la oftalmoparesia. Se ha sobreentendido un lógico compromiso de la arteria cerebral posterior (irriga el tercer par), también por necrosis isquémica de músculos extraoculares, o la génesis de un aneurisma inflamatorio de la arteria carótida 13 . La parálisis del nervio motor ocular común secundario a la ACG, es unilateral, dolorosa, sin compromiso pupilar, idéntica a la parálisis microvascular del nervio, sin embargo, se han descrito algunos casos con compromiso pupilar 14 .…”

Section: Discussionunclassified

Arteritis de células gigantes en el sistema vertebrobasilar, isquemias cerebelo-occipitales y parálisis III par. Caso clínico

Adolfo

et al. 2018

Rev. méd. Chile

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Arteritis de células gigantes en el sistema vertebrobasilar, isquemias cerebelo-occipitales y parálisis III par. Caso clínico adolFo del Canto a. 1,2 , FranCisCa Montoya s. 3 , roberto Marileo z. 3 , luis Cartier r. 1,2Giant cell arteritis of the vertebrobasilar system, posterior ischemia and palsy of the third nerve. Report of one case Giant cell arteritis is the most common vasculitis in patients aged over 50 years. We report an 89-year-old woman with significant weight loss and persistent frontal-occipital headaches lasting two months. The neurological examination at admission identified a decrease in visual acuity of the left eye, paralysis of the third cranial nerve of the right eye and alterations of body motility without objective signs of damage of the motor or sensitive pathways. Magnetic resonance imaging showed changes of the temporal artery wall and in both vertebral arteries, as well as bilateral cerebellar and occipital ischemic lesions. The Doppler ultrasound of the temporal arteries was compatible with Giant cell arteritis. Treatment with steroids was started. While receiving oral prednisone, the patient suffered new infarcts of the posterior territory, documented with a CAT scan. (Rev Med Chile 2018; 146: 1356-1360

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Giant cell arteritis presenting as oculomotor nerve palsy with pupillary dilatation

Cited by 26 publications

References 2 publications

Isolated Palsies of Cranial Nerves III, IV, and VI

Isolated Palsies of Cranial Nerves III, IV, and VI

Patient-reported involvement of the eighth cranial nerve in giant cell arteritis

Arteritis de células gigantes en el sistema vertebrobasilar, isquemias cerebelo-occipitales y parálisis III par. Caso clínico

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