Skip to main content
Log in

Incidence of pupillary involvement in ischemic oculomotor nerve palsies

  • Original Article
  • Published:
Annals of Ophthalmology

Abstract

The incidence of pupillary involvement in ischemic oculomotor nerve palsy (IONP) was determined from a review of Mayo Clinic charts from 1944 to 1991, and a review of the literature from 1960 to May 1995. Approximately one fifth of IONPs may involve the pupil, rendering their clinical distinction from compressive lesions problematic.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Hopf H, Gutmann L. Diabetic 3rd nerve palsy: evidence for a mesencephalic lesion. Neurology. 1990;40:1041–1045.

    PubMed  CAS  Google Scholar 

  2. Weber RB, Daroff RB, Mackey EA. Pathology of oculomotor nerve palsy in diabetics. Neurology. 1970;20:835–838.

    PubMed  CAS  Google Scholar 

  3. Slamovits TL, Hedges TR, Kupersmith TR, Newman NJ, Sadun AA, Sedwick LA. Neuro-Ophthalmology: Basic and Clinical Science Course. Vol. 5. San Francisco, Calif: American Academy of Ophthalmology; 1993:92.

    Google Scholar 

  4. Bajandas FJ, Kline LB. Neuro-Ophthalmology Review Manual. Thorofare, NJ: SLACK Inc; 1988:92.

    Google Scholar 

  5. Glaser JS. Infranuclear disorders of eye movement. In: Tasman W, Jaeger EA, eds. Duane's Clinical Ophthalmology. Vol. 2. Philadelphia, Pa: JB Lippincott; 1988:13.

    Google Scholar 

  6. Rucker CW. Paralysis of the third, fourth, and sixth cranial nerves. Am J Ophthalmol. 1958;46:787–794.

    PubMed  CAS  Google Scholar 

  7. Rucker CW. The causes of paralysis of the third, fourth, and sixth cranial nerves. Am J Ophthalmol. 1966;61:1293–1298.

    PubMed  CAS  Google Scholar 

  8. Richards B, Jones F, Younge B. Causes and prognosis in 4278 cases of paralysis of the oculomotor, trochlear, and adbucens cranial nerves. Am J Ophthalmol. 1992;113:489–496.

    PubMed  CAS  Google Scholar 

  9. Rush JA, Younge BR. Paralysis of cranial nerves III, IV. and VI. Arch Ophthalmol. 1981;99:76–79.

    PubMed  CAS  Google Scholar 

  10. Reddy PS, Reddy RC, Satapathy M. Aetiological study of the third, fourth and sixth cranial nerve paralysis. Indian J Ophthalmol. 1972;20:159–163.

    PubMed  CAS  Google Scholar 

  11. Teuscher AU, Meienberg O. Ischemic oculomotor nerve palsy. J Neurol. 1985;232:144–149.

    Article  PubMed  CAS  Google Scholar 

  12. Watanabe K, Hagura R, Akanuma Y, et al. Characteristics of cranial nerve palsies in diabetic patients. Diabetes Res Clin Pract. 1990;10:19–27.

    Article  PubMed  CAS  Google Scholar 

  13. Capo H, Warren F, Kupersmith M. Evolution of oculomotor nerve palsies. J Clin Neuro Ophthalmol. 1992;12:21–25.

    CAS  Google Scholar 

  14. Berlit P. Isolated and combined pareses of cranial nerves III, IV and VI: a retrospective study of 412 patients. J Neurol Sci. 1991; 103:10–15.

    Article  PubMed  CAS  Google Scholar 

  15. Naghmi R, Subuhi R. Diabetic oculomotor mononeuropathy: involvement of pupillomotor fibers with slow resolution. Horm Metab Res. 1990;22:38–40.

    PubMed  CAS  Google Scholar 

  16. Goldstein JE, Cogan DG. Diabetic ophthalmoplegia with special reference to the pupil. Arch Ophthalmol. 1960;64:144–152.

    Google Scholar 

  17. Demierre B, Safran A. Paralysies du IIIe nerf cranien d'origines ischemique et aneuvrysmale. J Fr Ophtalmol. 1981;4:133–141.

    PubMed  CAS  Google Scholar 

  18. Green WR, Hackett ER, Schlezinger NS. Neuro-ophthalmologic evaluation of oculomotor paralysis. Arch Ophthalmol. 1964;72:154–167.

    PubMed  CAS  Google Scholar 

  19. Balla JI, Morley JB. Oculomotor nerve paralysis. Med J Aust. 1967; 1:755–758.

    PubMed  CAS  Google Scholar 

  20. Renowden SA, Harris KM, Hourihan MD. Isolated atraumatic third nerve palsy: clinical features and imaging techniques. Br J Radiol. 1993;66:1111–1117.

    Article  PubMed  CAS  Google Scholar 

  21. Jacobson DM. Risk factors for ischemic ocular motor nerve palsier. Arch Ophthalmol. 1994;112:961–966.

    PubMed  CAS  Google Scholar 

  22. Van Laere E. Non-traumatic paralysis of the oculomotor nerve: a review of 109 cases. Acta Neurol Belg. 1974;74:182–192

    PubMed  CAS  Google Scholar 

  23. Rama V, Vimala J, Chanrasekhar M, Anjaneyulu C, Dinakar I. Ophthalmoplegia: a study of 90 cases. Indian J Ophthalmol. 1980;28:13–16.

    PubMed  CAS  Google Scholar 

  24. Hugonnier R, Magnard P. Une statistique de 501 paralysies oculomotrices et diplopies. Bull Mem Soc Fr Ophtalmol. 1960;73:80–89.

    PubMed  CAS  Google Scholar 

  25. Krishna AG, Mehkri MB. Ophthalmoplegia: a clinical analysis of 180 cases. Neurol Ind.. 1973;21(supplement 4):584–593.

    Google Scholar 

  26. Teasdale E, Statham P, Straiton J, Macpherson P. Non-invasive radiologic investigation for oculomotor palsy. J Neurol Neurosurg Psych. 1990;53:549–553.

    Article  CAS  Google Scholar 

  27. Hopf HC, Gutmann L. Masseter reflex abnormalities in thirdnerve palsies: evidence for a mesencephalic lesion. Neurology. 1987;37(suppl 1):115.

    Google Scholar 

  28. Brean LA, Farris BK, Gutmann L. Pupil-sparing oculomotor nerve palsy due to a midbrain infarct. Neurology. 1989;39:355.

    Google Scholar 

  29. Newman NJ, Lessell S. Isolated pupil-sparing third-nerve palsy as the presenting sign of multiple sclerosis. Arch Neurol. 1990;47: 817–818.

    PubMed  CAS  Google Scholar 

  30. Ksiazek SM, Repka MX, Maguire A. Divisional oculomotor nerve paresis caused by intrinsic brainstem disease. Ann Neurol. 1989; 26:714–718.

    Article  PubMed  CAS  Google Scholar 

  31. Castro O, Johnson LN, Mamorian AC. Isolated inferior oblique paresis from brain-stem infarction: perspective on oculomotor fascicular organization in the ventral midbrain tegmentum. Arch Neurol. 1990;47:235–237.

    PubMed  CAS  Google Scholar 

  32. Ksiazek S, Slamovits T, Rosen C, Burde R, Parisi F. Fascicular arrangement in partial oculomotor paresis. Am J Ophthalmol. 1994;118:97–103.

    PubMed  CAS  Google Scholar 

  33. Jacobson DM. A prospective evaluation of cholinergic supersensitivity of the iris sphincter in patients with oculomotor nerve palsies. Am J Ophthalmol. 1994;118:377–383.

    PubMed  CAS  Google Scholar 

  34. Blumen SC, Feiler-Ofry V, Korczyn AD. Does pupil-sparing oculomotor nerve palsy really spare the pupil? J Clin Neuro Ophthalmol. 1991;11:92–94.

    CAS  Google Scholar 

  35. Kissel J, Burde R, Klingele T, Zeiger H. Pupil-sparing oculomotor palsies with internal carotid-posterior communicating artery aneurysms. Ann Neurol. 1983;13:149–154.

    Article  PubMed  CAS  Google Scholar 

  36. O'Connor PS, Tredici TJ, Green RP. Pupil-sparing third nerve palsies caused by aneurysm. Am J Ophthalmol. 1983;95:395–397.

    PubMed  Google Scholar 

  37. Trobe J. Isolated pupil-sparing third nerve palsy. Ophthalmology. 1985;92:58–61.

    PubMed  CAS  Google Scholar 

  38. Guy J, Day A. Intracranial aneurysms with superior division paresis of the oculomotor nerve. Ophthalmology. 1989;96:1071–1076.

    PubMed  CAS  Google Scholar 

  39. Cullom M, Savino P, Sergott R, Bosley T. Relative pupillary sparing third nerve palsies: to arteriogram or not? J Neuro Ophthalmol. 1995;15:136–141.

    CAS  Google Scholar 

  40. Halpern B, Pavilack M, Gallagher S. The incidence of atonic pupil following cataract surgery. Arch Ophthalmol. 1995;113:448–450.

    PubMed  CAS  Google Scholar 

  41. Earnest F, Forbes G, Sandok B, et al. Complications of cerebral angiography: prospective assessment of risk. Am J Roentgenol. 1984;142:247–253.

    Google Scholar 

  42. Keller PJ, Drayer BP. Magnetic resonance angiography. Neuroimag Clin North Am. 1992;2:623–635.

    Google Scholar 

  43. Pernicone JR, Thorp KE, Ouimette MV, Siebert J, Potchen E. Magnetic resonance angiography in intracranial vascular disease. Semin Ultrasound CT MRI. 1992;13:256–273.

    CAS  Google Scholar 

  44. Ross JS, Masaryk TJ, Modic MT, Ruggieri P, Haacke E, Selman W. Intracranial aneurysms: evaluation by MR angiography. Am J Neuroradiol. 1990;11:448–455.

    Google Scholar 

  45. Sevick RJ, Tsuruda JS, Schmalbrook P. Three dimensional time-of-flight MR angiography in the evaluation of cerebral aneurysms. J Comput Assist Tomogr. 1990;14:874–881.

    Article  PubMed  CAS  Google Scholar 

  46. Bradley WG. MRA abets visualization of intracranial aneurysms. Diagn Imaging. 1992;14:122–128.

    Google Scholar 

  47. Blatter D, Parker D, Ahn S. Cerebral MR angiography with multiple overlapping thin slab acquisition. Radiology. 1992;183:379–389.

    PubMed  CAS  Google Scholar 

  48. Weinberg D. Negative MRI versus real disease. Surv Ophthalmol. 1996;40:312–319.

    Article  PubMed  CAS  Google Scholar 

  49. Kaufman DI, Siebert JE, Pernicone JR. Magnetic resonance angiography relevant to neuro-ophathalmology. In: Tulsa RJ, Newman SA, eds. Neuro-Ophthalmological Disorders: Diagnostic Work-up and Management. New York, NY: Marcel Dekker Inc, 1995:367–402.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ing, E.B., Leavitt, J.A. & Younge, B.R. Incidence of pupillary involvement in ischemic oculomotor nerve palsies. Ann Ophthalmol 32, 90–94 (2000). https://doi.org/10.1007/s12009-000-0022-5

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12009-000-0022-5

Keywords

Navigation