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Cranial mononeuropathy III
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Cranial mononeuropathy III

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Third cranial nerve palsy; Oculomotor palsy; Pupil-involving third cranial nerve palsy; Mononeuropathy - compression type

Cranial mononeuropathy III is a nerve disorder. It affects the function of the third cranial nerve. As a result, the person may have double vision and eyelid drooping.

I Would Like to Learn About:

  • Causes

    Cranial mononeuropathy III is a mononeuropathy, which means that only one nerve is affected. It affects the third cranial (oculomotor) nerve. This is one of the cranial nerves that control eye movement. Local tumors or swelling can press on and damage the nerve.

    Causes may include:

    • Brain aneurysms
    • Infections
    • Abnormal blood vessels (vascular malformations)
    • Sinus thrombosis
    • Tissue damage from loss of blood flow (infarction)
    • Trauma (from head injury or caused accidentally during surgery)
    • Tumors or other growths (especially tumors at the base of the brain and pituitary gland)

    In rare cases, people with migraine headaches may have a temporary problem with the oculomotor nerve. This is probably due to a spasm of the blood vessels. In some cases, no cause can be found.

  • Symptoms

    Symptoms may include:

    • Double vision, which is the most common symptom
    • Drooping of one eyelid (ptosis)
    • Enlarged pupil that does not get smaller when a light shines on it
    • Headache or eye pain

    Other symptoms may occur if the cause is a tumor or swelling of the brain. Decreasing alertness is serious, because it could be a sign of brain damage or impending death.

  • Exams and Tests

    An eye examination may show:

    • Enlarged (dilated) pupil of the affected eye
    • Eye movement abnormalities
    • Eyes that are not aligned

    Your health care provider will do a complete examination to determine the possible effect on other parts of the nervous system. Depending on the suspected cause, you may need:

    • Blood tests
    • Tests to look at blood vessels to the brain (cerebral angiogram, CT angiogram, or MR angiogram)
    • MRI or CT scan of the brain
    • Spinal tap (lumbar puncture)

    You may need to be referred to a doctor who specializes in vision problems related to the nervous system (neuro-ophthalmologist).

  • Treatment

    Some people get better without treatment. Treating the cause (if it can be found) may relieve the symptoms.

    Treatment may include:

    • Corticosteroid medications to reduce swelling and relieve pressure on the nerve (when caused by a tumor or injury)
    • Eye patch or glasses with prisms to reduce double vision
    • Pain medications
    • Surgery to treat eyelid drooping or eyes that are not aligned
  • Outlook (Prognosis)

    Some patients will respond to treatment. A few cases result in permanent eye drooping or loss of eye movement.

    Causes such as brain swelling due to a tumor or stroke, or a brain aneurysm may be life threatening.

  • When to Contact a Medical Professional

    Call your health care provider if you have double vision and it does not go away in a few minutes, especially if you also have eyelid drooping.

  • Prevention

    Quickly treating disorders that could press on the nerve may reduce the risk of developing cranial mononeuropathy III.

Related Information

  Eyelid droopingMononeuropathyAneurysmMononeuritis multi...Migraine     Migraine headaches...

References

Rucker JC. Cranial neuropathies. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 70.

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Review Date: 5/20/2014  

Reviewed By: Joseph V. Campellone, M.D., Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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