title: Pupil-involving third nerve palsy as a manifestation of anti-myelin-associated glycoprotein neuropathy.
abstract: A 56-year-old man developed a pupil-involving left third nerve palsy. Imaging studies of the brain and intracranial vessels were normal. Neurological examination demonstrated a sensory polyneuropathy and mild distal weakness. Nerve conduction studies showed prolonged distal motor latencies. An enzyme-linked immunosorbent assay test detected high titers of anti-myelin-associated glycoprotein (MAG) antibodies. The patient improved with prednisone and rituximab treatment. Anti-MAG neuropathy should be considered when evaluating a patient with an undiagnosed cranial neuropathy, especially in the setting of a sensory neuropathy.
authors.affiliation: Department of Ophthalmology, Scheie Eye Institute, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. madhura.tamhankar@uphs.upenn.edu
authors.forename: Madhura A
authors.initials: MA
authors.lastname: Tamhankar
authors.forename: Steven L
authors.initials: SL
authors.lastname: Galetta
authors.forename: Mina
authors.initials: M
authors.lastname: Massaro
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Balcer
authors.forename: Edward A
authors.initials: EA
authors.lastname: Stadtmauer
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Brown
mesh_terms: D001323:Autoantibodies / Q000096:biosynthesis / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018992:Myelin-Associated Glycoprotein / Q000276:immunology*; D015840:Oculomotor Nerve Diseases / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology*; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology*; D011680:Pupil / Q000502:physiology
chemical_list: D001323:Autoantibodies; D018992:Myelin-Associated Glycoprotein