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Title | Creator | History |
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Fooled Thrice | Jonathan Micieli; Hui-Kuo Shu; Alessandra Schmitt; Nancy Newman | A 40-year-old healthy man presented with a one-month history of left ptosis and binocular horizontal diplopia. Examination revealed normal afferent visual function. He had left ptosis and there was limitation of elevation, depression, adduction and a dilated, sluggishly reactive pupil in the left ey... |
2 |
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Fooled Thrice | Jonathan Micieli; Hui-Kuo Shu; Alessandra Schmitt; Nancy Newman | A 40-year-old healthy man presented with a one-month history of left ptosis and binocular horizontal diplopia. Examination revealed normal afferent visual function. He had left ptosis and there was limitation of elevation, depression, adduction and a dilated, sluggishly reactive pupil in the left ey... |
3 |
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Mechanism of Oculomotor Synkinesis | Patrick Sibony, MD, Stony Brook Medicine | A 69-year old female with periocular pain OD and ptosis. |
4 |
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Warwick's Hypothesis Confirmed | Harbour, Robert C. | A 49-year old male with diplopia and anisocoria. Previous history significant for hypertension and hemorrhagic cerebrovascular accident. |
5 |
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Ophthalmoplegic Migraine: Toward a Better Understanding | Alexander S. Mark | A 12-year old with headaches and right III nerve palsy involving the pupil. |
6 |
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Partial Third Nerve Palsies in a Child with Complex Partial Seizures | Elizabeth C. Dooling | A 12-year old female with a 3-week history of ptosis and diplopia OD. |
7 |
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Third Nerve Palsy with Progressive Spinal Cord Dysfunction | Hepler, R. | A 45-year old female with a right third nerve palsy that three months prior commenced with progressive ptosis. |
8 |
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Acute Third Nerve Palsy in a Malformed Dwarf | Nicholas J. Volpe, MD, Northwestern University | A 28-year old male with headache and ptosis. Previous history significant for physical abnormalities and seizures consistent with an underlying heritable syndrome. |
9 |
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An Unusual Cause of Isolated Third Nerve Palsy in an Infant | Barbas, Nancy R. | A 9-month old male with drooping ptosis and limitation of movement OD. |
10 |
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Unilateral Intranuclear Ophthalmoplegia | Hardman, John | A 67-year old female with a 10-year history of rheumatoid arthiritis treated with steroids developed progressive neurologic deterioration over an 8-week period. |
11 |
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Third Nerve Palsy in a South American Girl | Howard R. Krauss | A 13-month old female referred from Caracas, Venezuela with a right third nerve palsy. |
12 |
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The Ophthalmoplegic Migraine Train | John Kerrison, MD, Retina Consultants of Charleston | A 48-year old female with a history of chronic recurrent headache and painful ophthalmoplegia. Previous history significant for diabetes mellitus. |
13 |
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Curtains | Paul Phillips; Edgardo Angtuaco; Lamonda Slape | A 51-year old male with headache, photophobia, fatigue, loss of appetite and low-grade fever. Referral made for bilateral ptosis, diplopia and headache. Previous history significant for chronic back pain and rheumatic fever. |
14 |
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Curtains (PowerPoint) | Paul Phillips; Edgardo Angtuaco; Lamonda Slape | A 51-year old male with headache, photophobia, fatigue, loss of appetite and low-grade fever. Referral made for bilateral ptosis, diplopia and headache. Previous history significant for chronic back pain and rheumatic fever. |
15 |
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Painful Ophthalmoplegia Following Cataract Extraction | Lanning B. Kline | A 77-year old male developed peri-orbital pain and III and IV nerve palsies after a left extracapsular cataract extraction with insertion of a posterior chamber lens. |
16 |
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Nuclear Magnetic Resonance Imaging in Bilateral Oculomotor Nerve Palsy | Thomas J. Zweifel | A 35-year old male with an 11-day history of blurred vision in left horizontal gaze progressing to oblique diplopia and bilateral ptosis. |
17 |
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Bilateral 3rd Nerve Palsy in a 75 Year-Old Man | Valerie A. Purvin, MD, Indiana University | A 75-year old male with painless diplopia and right upper lid ptosis. |
18 |
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An Unusual Case of Third Nerve Palsy | Hiroshi Mitsumoto | A 43-year old female with ascites and a pelvic mass. Previous history significant for facial pain, double vision and right-sided ptosis. |
19 |
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Diffusion, Perfusion, Confusion | Roger E. Turbin, MD, Rutgers New Jersey Medical School | A 49-year old female underwent uncomplicated repeat cardiac catheterization for recurrent crescendo angina 26 days after a coronary artery stent was placed. Previous history significant for diabetes. |
20 |
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To Get If Off My Chest | Steven A. Newman, MD, University of Virginia School of Medicine | A 17-year old male with a 1-month history of right frontal headache, progressive right ptosis and diplopia. |
21 |
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The Terrible Threes | Mays El-Dairi; Kim Jiramongkolchai; Thomas Cummings; M. Tariq Bhatti | A 3-year old female with a third cranial nerve palsy. One year prior to presentation, vomiting, headache noted along with left ptosis and anisocoria: Dx Horner Syndrome. |
22 |
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The Terrible Threes (PowerPoint) | Mays El-Dairi; Kim Jiramongkolchai; Thomas Cummings; M. Tariq Bhatti | A 3-year old female with a third cranial nerve palsy. One year prior to presentation, vomiting, headache noted along with left ptosis and anisocoria: Dx Horner Syndrome. |
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Kryptonite Nevermore | Michael Vaphiades, DO | A 65-year old male with progressive painful binocular diplopia, followed by ptosis and fixed and dilated pupil OD. Previous history significant for angina and hypertension. |
24 |
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Primary Aberrant Regeneration of the Thrid Nerve at Its Emergence from the Midbrain | James J. Corbett, MD, University Of Mississippi | A 49-year old female with a 2-week history of enlarged left pupil, droopy lid, pain and visual loss OS and double vision on right gaze. |
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Cross Your 'I's' (Eyes) and Dot Your 'T's' (Threes) | Robert D. Yee, MD | A 72-year old male with a 50-year history of low back pain, weakness and sensory loss in the legs Tx 6 surgeries over 32 years. Leg weakness and numbness progressed with subsequent bladder and bowel incontinence and severe bilateral hearing loss. |
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A Flu-Like Illness | Shirley H. Wray, MD, PhD, FRCP, Professor of Neurology Harvard Medical School, Director, Unit for Neurovisual Disorders, Massachusetts General Hospital | A 50-year old male with 5-month history of flu-like illness characterized by mild fevers, frequent chills, night sweats, sinus congestion and diffuse myalgias in chest, abdomen, legs and soles of the feet. Three days PTA awoke unable to open his right eye. Diplopia with eye open. Previous history s... |
27 |
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An Apple a Day | Joseph Fong; James O'Brien; Anil Patel | A 73-year-old female presented with a 4-month-history of gradually worsening binocular oblique diplopia, right upper; eyelid ptosis, right-sided facial weakness, and facial pain and paresthesia in the right V1 and V2 distribution. She presented; with a prior diagnosis of trigeminal neuralgia as a re... |
28 |
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Jacobson's Rule | Robert L. Lesser, MD, The Eye Care Group, Clinical Professor of Ophthalmology and Visual Science and Neurology at Yale, Clinical Professor of Neurology and Surgery (Neurosurgery) at the University of Connecticut School of Medicine | A 75-year old female with a sudden onset of vertical diplopia associated with a throbbing sensation on the right retro-orbital side. |
29 |
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Where Does the Basilar Artery Stop? An Unusual Case of Posterior Circulation Ischemia | Frederick E. Lepore | A 91-year old male found unresponsive with bilateral prosis and exotropia. Previous history significant for cervical arthritis and a cardiac condition requiring digoxin. |
30 |
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Isolated Third Nerve Palsy Caused by Intracranial Spread (Powerpoint) | Celia Chen, MD, MPH; Neil Miller, MD; Andrew Lane, MD; Charles Eberhart, MD | A 53-year old male with a 1-month history of diplopia and swelling OD. Previous history significant for systemic lupus erythematosus. |
31 |
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Isolated Third Nerve Palsy Caused by Intracranial Spread of Idiopathic Orbital Inflammation? | Celia Chen, MD, MPH; Neil Miller, MD; Andrew Lane, MD; Charles Eberhart, MD | A 53-year old male with a 1-month history of diplopia and swelling OD. Previous history significant for systemic lupus erythematosus. |
32 |
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Question Not Asked | William A. Fletcher, MD, Departments of Clinical Neurosciences & Surgery, University of Calgary | A 62-year old male developed a sensation of water running over his head in the left temporo-parietal region. Previous history significant for skin cancer. |
33 |
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Tracking Down the Third Nerve | Dina A. Jacobs, MD; Josep Dalmau, MD, PhD; Ethan Stolzenberg, MD, PhD; Nicholas Volpe, MD | A 37-year old female with drooping left lid and diplopia. Previous history significant for a prolactinoma Dx when presented at 9-years with vision loss and field defect OS. Tx: Radiotherapy |
34 |
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An Ocular Myasthenic Syndrome | Mark J. Kupersmith, MD, Mount Sinai | A 15-month old male developed droopy eyelids the day he suffered minor head trauma. Subsequently, over a 2-week period lethargy and fatigue were manifest. |
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A Definite Maybe | Raghu Mudumbai; Alex Solomon | 73 yo man French-Canadian presented to our institution for another opinion for a long standing diagnosis of Oculopharyngeal Dystrophy given at an outside institution. 17 years ago, the patient developed unfluctuating double vision that progressed to include severe, unfluctuating ptosis and mild dysp... |