Ocular motor nerve palsy: a clinical and etiological study.
OBJECTIVE
To clinically describe cases of ocular motor nerve palsy and to determine the possible causes.


METHODS
Thirty-one consecutive patients with ocular motor nerve palsies were investigated. All underwent complete ophthalmological, as well as neurological, otorhinolaryngological and general examination. Computerised tomography (CT)-scan of the brain and complementary laboratory tests were obtained from each participant.


RESULTS
Paralysis of the sixth (38.4%) and the third (35.3%) cranial nerve were the most common. The Lees screen test was found to be very sensitive, confirming the diagnosis of ocular motor nerve palsy, even in cases with minimal manifestations. Complete ptosis and full mydriasis were mostly seen in isolated cases of the third cranial nerve palsy. The majority of eyes (63.2%) with third cranial nerve palsy had pupil sparing. Overall, an etiological diagnosis was made in 93.5% of cases. The common causes were vascular conditions (25.8%), otorhinolaryngologic diseases (19.7%) and trauma (12.9%). CT scan failed to reveal any abnormality in 54.8% of cases.


CONCLUSIONS
Patients with ocular motor nerve palsy should be carefully examined in close collaboration with other specialists, especially where sophisticated, complementary investigations are impossible.
Mwanza
Jean-Claude
JC
Kinshasa University Hospital, Kinshasa, Democratic Republic of Congo. jcmwanza@hotmail.com
Ngweme
Georgette B
GB
Kayembe
David L
DL
D000293:Adolescent; D000328:Adult; D002648:Child; D003937:Diagnosis, Differential; D003941:Diagnostic Techniques, Ophthalmological; D005151:Facial Injuries / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015840:Oculomotor Nerve Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D010038:Otorhinolaryngologic Diseases / Q000150:complications*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014652:Vascular Diseases / Q000150:complications*