Superior Division Paresis of the Oculomotor Nerve: Report of Four Cases

A 27-year-old man with diplopia, fatiguable ptosis and rash: a rare presentation of angiocentric T cell lymphoma with lymphomatoid vasculitis

“…This variant accounts for less than 1% of all cutaneous T cell lymphomas with a median age of presentation of 54 years (range 13–82 years) and a male:female ratio of 16:7 7 9. There are few reported cases of angiocentric lymphoma involving the cranial nerves 1–3. Two distinct γδ-T cell lymphoma entities are recognised: hepatosplenic T cell lymphoma and primary cutaneous γδ-T cell lymphoma as seen in this case.…”

“…The skin biopsy showed an infiltrating lymphomatoid vasculitis causing perineural vascular inflammation. A likely explanation for this patient's presentation is that the same lymphomatoid vasculitic pathology occurred in his cranial nerves with direct perineural involvement of the superior divisions of both third nerves (preferentially affecting some fascicles) and other cranial nerves as well, that is, right-sided sixth and fifth nerves (the latter causing facial dysaesthesia) 1 3 6. The prognosis of patients with angiocentric T cell lymphoma is poor with reported median survival of 15 months 7 8…”

Unusual presentations of cavernous carotid aneurysms: Further evidence for topographic organization of the oculomotor nerve

“…Likewise the superomedial location of the pupillo-motor fibers at the oculomotor nerve exit from the midbrain to the subarachnoid space has been shown in experiments conducted on dogs [24,25]. A number of reports describe various forms of partial oculomotor paresis caused by midbrain fascicular lesions [7][8][9][10][11][18][19][20][21].…”

“…Several case reports have demonstrated that paresis of a single muscle subserved by the oculomotor complex can occur from a lesion that is located anywhere from the oculomotor nucleus to the myoneural junction [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. A superior division third nerve palsy causing isolated elevation deficit and ptosis is often present with lesions in the cavernous sinus-orbital apex region.…”

Ptosis and Elevation Paresis Due to Mesencephalic Infarction

“…Isolated paresis of either the superior [1][2][3][4][5][6] or inferior 7,8 division of the oculomotor nerve has rarely been reported and occasional case reports are present about fascicular lesions due to vascular or demyelinating diseases. 1,6,8 Our case with brainstem infarction indicates the importance of neuroradiological studies including diffusion-weighted MRI in patients with fascicular involvement.…”