Levator-sparing oculomotor nerve palsy caused by a solitary midbrain metastasis.
One month before death, a 63-year-old man with known lung carcinoma manifested a left third-nerve palsy and crossed ataxia. The oculomotor involvement began with a dilated left pupil and progressed to a complete left oculomotor nerve palsy, with the exception of nearly normal lid function. Pathologic examination revealed a solitary midbrain metastasis involving the left third-nerve nucleus and rootlets, with the exception of the caudal central oculomotor subnucleus and its outflow fibers.
D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology / Q000556:secondary*; D001932:Brain Neoplasms / Q000150:complications / Q000473:pathology / Q000556:secondary*; D006801:Humans; D008175:Lung Neoplasms; D008297:Male; D008636:Mesencephalon / Q000473:pathology; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000150:complications* / Q000473:pathology