title: Idiopathic repetitive oculomotor nerve palsies in otherwise normal patients.
abstract: 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.
authors.affiliation: Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota 55455, USA. leex2679@umn.edu
authors.forename: Michael S
authors.initials: MS
authors.lastname: Lee
authors.forename: Robert A
authors.initials: RA
authors.lastname: Egan
authors.forename: William T
authors.initials: WT
authors.lastname: Shults
authors.forename: Simmons
authors.initials: S
authors.lastname: Lessell
mesh_terms: 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