Isolated third cranial nerve palsy

Abstract

The present report deals with the case of a 55 year-old patient who presented with isolated third cranial nerve palsy. The clinical picture was characterized by moderate to severe retroocular pain followed by diplopia (double vision). During the physical examination, left palpebral ptosis and ocular motility alteration were observed, without pupillary involvement. Considering the patient's pathologic history (diabetes mellitus and arterial hypertension), ischemic etiology was considered the most probable. However, in the differential diagnosis of this type of paralysis there is no clear consensus on the need to request routine neuroimaging. The aim of this case report is to evaluate the differential diagnoses to be considered in patients with this condition, which include aneurysmal, infectious, ischemic, traumatic causes, among others.