Walsh & Hoyt: Motility Disorders: Congenital

Congenital oculomotor nerve palsies are rarer than acquired palsies, but they constitute nearly half of the oculomotor nerve pareses seen in children. Most cases are unilateral, but bilateral cases also occur. As a general rule, patients with congenital oculomotor nerve palsy have no other neurologic or systemic abnormalities, but there are many reports of associated problems such as additional cranial nerve dysfunction, developmental delay, asymmetric hypoplasia of the midbrain and corpus callosum, septo-optic dysplasia, and cerebral palsy. Most cases are sporadic, although rare familial cases occur.