Idiopathic repetitive oculomotor nerve palsies in otherwise normal patients.
OBJECTIVE
To describe a unique idiopathic disorder characterized by transient repetitive unilateral oculomotor pareses.


METHODS
Retrospective observational case series.


METHODS
Three women presenting for tertiary neuro-ophthalmologic evaluation.


METHODS
Review of patient records.


METHODS
Historical information, clinical examination, neuroimaging, and laboratory evaluation for myasthenia gravis.


RESULTS
Three 44- to 69-year-old women had recurrent unilateral ptosis over the course of 2 to 4 years. Two had concurrent diplopia with ipsilateral limitation of adduction, and 2 also had a large poorly reactive pupil in the involved eye during the episodes. The attacks lasted between 30 seconds and 4 hours and occurred up to 6 times daily. None of the patients were migraineurs, nor had they received radiation therapy. Neuro-ophthalmologically normal between episodes, all patients had normal magnetic resonance imaging/angiography and testing for myasthenia gravis.


CONCLUSIONS
Transient, recurrent, unilateral oculomotor nerve palsies may occur spontaneously in healthy individuals. The pathogenesis remains obscure, but the multiple recurrences without evident sequelae and the failure to develop any systemic or neurological disorder suggest that this phenomenon is not indicative of a serious underlying disorder.
Lee
Michael S
MS
Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota 55455, USA. leex2679@umn.edu
Egan
Robert A
RA
Shults
William T
WT
Lessell
Simmons
S
D000328:Adult; D000368:Aged; D001763:Blepharoptosis / Q000150:complications; D004172:Diplopia / Q000150:complications; D005260:Female; D006801:Humans; D008875:Middle Aged; D015840:Oculomotor Nerve Diseases / Q000150:complications* / Q000175:diagnosis; D012008:Recurrence; D012189:Retrospective Studies