Occulomotor Limitation
February 15th, 2021
Oculomotor Nerve (III) Palsy
Look For
- Eye deviated down and out
- Diplopia
- Ptosis
- Mydriasis (pupillary dilatation)
- Loss of pupillary reflexes
Causes of Occulomotor Nerve Palsy
- Small-vessel ischaemia
- Midbrain infarct
- Head trauma
- Tumour
- Aneurysm (commonly PCA)
Trochlear Nerve (IV) Palsy
Look For
- Head tilting away from the side of the lesion
- Eye deviation upward and rotation outward
- Vertical diplopia
- Inability to look down and in - difficulty descending stairs
Causes of Trochlear Nerve Palsy
- Congenital absence
- Closed head injury
- Small-vessel ischaemia
- Multiple sclerosis
Abducens Nerve (VI) Palsy
Look For
- Inwardly-turned eye
- Horizontal diplopia
- Inability to look laterally
Causes of Palsy
- Small-vessel ischaemia
- Head trauma
- Tumour
- Aneurysm
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