title: Ocular signs due to an oculomotor intranuclear lesion: palsy of adduction and contralateral eye elevation.
abstract: Reports on ocular signs of discrete oculomotor nuclear lesions have been rare. This is a case report of a patient with the sudden onset of limited adduction on the left side and bilateral elevation palsy, more pronounced on the right side. The symptoms lasted for 3 days. Neuroimaging study did not reveal a responsible lesion. The patient was diagnosed as having a lacunar infarct. It is neuroanatomically established that the oculomotor subnucleus to the superior rectus muscle primarily cross-innervates the muscle. The palsy of adduction and contralateral supraduction is most plausibly explained by a partial oculomotor nuclear lesion. This patient demonstrated the intranuclear close arrangement of the nerves for the superior and medial rectus muscles. This case reminds us of the clinical importance of basic anatomy based neurological examinations in this computer orientated, high tech era.
authors.affiliation: Department of Neurological Surgery, Chiba University School of Medicine, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Saeki
authors.forename: A
authors.initials: A
authors.lastname: Yamaura
mesh_terms: D000328:Adult; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D015840:Oculomotor Nerve Diseases / Q000150:complications*; D010243:Paralysis / Q000209:etiology*; D014057:Tomography, X-Ray Computed / Q000379:methods