CLINICAL-STUDIES OF OCULAR MOTILITY DISTURBANCES .1. OCULAR MOTILITY DISTURBANCES - CAUSES AND INCIDENCE

Between January 1985 and December 1994, 500 cases of ocular motility d isturbances were encountered in our department; we analyzed these stat istically. There were 48 cases of supranuclear palsy (10%), 281 of ocu lar motor nerve palsies (56%), 19 with myasthenia gravis (4%), 29 with myogenic palsy (6%), 57 with abnormal innervation (11%), and 63 insta nces of mechanical disturbances (13%). There were more men than women in all groups except myasthenia gravis. Eighty-four ocular motor nerve palsy and 15 blowout fracture patients recovered spontaneously. Spont aneous recovery occurred within 6 months in 80 (93%) patients with ocu lar motor nerve palsy. The abnormality detection rate, using diagnosti c imaging, was high for supranuclear and myogenic palsy and the mechan ical disturbance groups, but very low for the ocular motor nerve palsy groups. In 3 supranuclear palsy patients, small infarctions of the br ainstem were discovered by magnetic resonance imaging (MRI) but were n ot found with computed tomography (CT). MRI thus proved useful in dete cting abnormalities of brainstem lesions.