Walsh and Hoyt's Clinical Neuro-Ophthalmology

Nuclear and Infranuclear Ocular Motility Disorders

"Lesions of the oculomotor, trochlear, and abducens nerves may be located anywhere from the ocular motor nuclei to the termination of the nerves in the extraocular muscles in the orbit."

"Lesions of the oculomotor, trochlear, and abducens nerves may be located anywhere from the ocular motor nuclei to the termination of the nerves in the extraocular muscles in the orbit. Ocular motor nerve palsies present to the clinician in one of four ways: (a)as an isolated partial or complete nerve palsy without any other neurologic signs and without symptoms except those related to the palsy itself; (b)in association with symptoms such as pain or proptosis, but without any signs of neurologic or systemic disease; (c)in associa-tion with other ocular motor nerve palsies, but without any other neurologic signs; and (d)in association with other neurologic signs. Most large series that document the percentage of ocular motor nerve palsies caused by each pathologic condition ignore these modes of presentation and thus are of limited value to the clinician. For this reason, we discuss ocular motor nerve palsies in relation to their presentation, their known or presumed site of origin, and the lesions that cause them."