no
no
no

Third nerve palsy for PACES


The eye is deviated downwards and outwards.
There is ptosis.
The pupil is dilated, indicating that there is parasympathetic damage (= a 'surgical' third nerve palsy)/ the pupil is not dilated, indicating no parasympathetic damage (= a 'medical' third nerve palsy)


Quick recap of the muscles of eye movement:


What causes of a 'medical' third nerve palsy do you know?
  • mononeuritis multiplex  - classically diabetes
  • MS
  • midbrain infarction
  • migraine

What causes of a 'surgical' third nerve palsy do you know?

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Abdelghafour

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Secret collector of interesting anonymised ECGs. Fan of the Bath Photomarathon. Lover of cream teas. [Sarah Hudson] (Your Picture)