Causes of Isolated Oculomotor Nerve Palsy in Patients Presenting to Eye Outpatient Department at Shree Birendra Hospital.

Abstract

Introduction: Although oculomotor nerve palsy is associated with signifycant morbidity. The etiology of oculomotor nerve palsy are ischemic, trauma, aneurysm, tumors, inflammatory, idiopathic etc. The present study was performed to determine the etiology of isolated oculomotor nerve palsy in our population.

Methods: The hospital data of patients of isolated oculomotor nerve palsy cases reported to the eye department of Shree Birendra Hospital from March 2009 to March 2011 were collected and retrospectively analyzed for the etiology of the disease. The detail history (ocular and medical), examination and investigations were collected from patient’s case records. All patients had been evaluated for hypertension and diabetes mellitus. Neuroimaging, MRI had been performed in all cases. The etiology of isolated oculomotor nerve palsy was classified into ischemia, idiopathic, trauma, aneurysm and neoplastic.

Results: During the study period there were 16 eyes of 16 patients who were suffering from isolated oculomotor nerve palsy. The commonest cause was found to be ischemic in 7 patients (43.75%) followed by idiopathic in 5 patients (31.25%). Pupil was involved in 3 patients (18.75%). MRI was carried out in all 16 patients, but revealed positive only in two cases (one intracranial aneurysm and other Non Hodgkin’s Lymphoma). Remaining 14 MRI were normal.

Conclusions: Oculomotor nerve palsy is an uncommon disease and commonest cause was ischemic followed by idiopathic. The cause should be ruled out as the treatment depends on the cause.

Medical Journal of Shree Birendra Hospital; Jan-June 2012/vol.11/Issue1/21-23

DOI: http://dx.doi.org/10.3126/mjsbh.v11i1.7762