Ischaemic Oculomotor Nerve Palsy Isolated to the Levator: A Case Report

ABSTRACT

Ischaemic oculomotor nerve (CN III) palsies frequently present with abrupt onset ptosis, ophthalmoplegia, diplopia, ipsilateral pain, and little to no anisocoria. An isolated microvascular ischaemic insult to the superior division of CN III is uncommon, and usually affects both the superior rectus and levator muscles. We present a rare case of an ischaemic CN III palsy isolated to the levator palpebrae superioris muscle only. Although rare, microvascular ischaemic CN III palsies should be on the differential of isolated ptosis. Other causes of isolated ptosis, such as myasthenia gravis or an orbital lesion, should be excluded.

KEYWORDS:

• Oculomotor nerve palsy
• CN III palsy
• microvascular
• ptosis

Acknowledgements

This work was supported in part by an unrestricted grant to the Department of Ophthalmology by Research to Prevent Blindness, Inc., New York, NY.

Declaration of interest

No conflicting relationship exists for any author.

Meeting Presentation

None.

Additional information

Funding

Research to Prevent Blindness, Inc., New York, NY. The sponsor or funding organization had no role in the design or conduct of this research.