ISOLATED ATRAUMATIC 3RD NERVE PALSY - CLINICAL-FEATURES AND IMAGING TECHNIQUES

We have reviewed 34 consecutive patients imaged for an isolated third nerve palsy over a 2-year period. With pupil sparing the third nerve p alsy was most often due to ischaemic microvascular disease. The common est cause of a third nerve palsy with pupillary involvement was a post erior communicating artery aneurysm. Clinical features such as speed o f onset, pain and completeness of palsy were not reliable in the diagn osis of either the nature or the location of the cause. Pupillary invo lvement was however often associated with a compressive lesion. Imagin g along the whole course of the nerve is recommended for adequate eval uation.