Bilateral oculomotor nerve palsy due to dolichoectasia of the basilar artery

Abstract

This report presents the case of an 85-year-old woman who slowly developed an isolated oculomotor nerve palsy over a period of two years. Initially, only the left eye was affected, but later the palsy became bilateral. Eventually, there was paralysis of all the extra-and intra-ocular muscles innervated by the third nerve and its parasympathetic pupillomotor fibers. High-resolution computer tomography (CT) demonstrated a basilar artery dolichoectasia, a condition which consists of elongation and dilatation of the vessel. A compressive lesion due to the ectatic artery appears to be the most likely cause of the complete bilateral oculomotor nerve palsy.

Key Words:

• Oculomotor nerve palsy
• ptosis
• ophthalmoplegia
• basilar artery
• dolichoectasia