Bilateral Fascicular Third Nerve Palsy in Posterior Circulation Stroke

ABSTRACT

Third nerve palsy is bilateral in only about 10% of cases, of which one in five cases is due to brainstem stroke. Bilateral oculomotor nerve palsy as an isolated clinical finding after brainstem stroke is extremely rare. We present a case of severe bilateral fascicular oculomotor nerve palsy due to distal basilar occlusion and subsequent midbrain infarction of cardioembolic origin. The patient required mechanical aids and subsequent ptosis surgery to relieve complete ptosis at least unilaterally.

KEYWORDS:

• Oculomotor
• brainstem
• stroke; bilateral
• ptosis

Patient consent

The patient described in this case report consented in written form to publication of all data and imaging files related to the case.

Declaration of interest

The authors declare that there are no conflicts of interest. The authors alone are responsible for the writing and content of the article.

Additional information

Funding

No financial support was received during the preparation of this publication.