Abstract Details

Title Etiology and Prognosis of Third Cranial Nerve Palsy

Topic Neuro-ophthalmology/Neuro-otology

Presentation(s) P06 - (-)

Poster/Presentation
Number 016

Objective

Background BACKGROUND: Previous studies of CNIII palsy have variable inclusion criteria, have data collected before the common use of MRI, include other cranial nerve palsies in their analyses, have small cohorts, or report only single etiologies or limited age groups. We report the largest current cohort of CNIII palsy with clearly defined inclusion, exclusion, and outcome criteria with detailed comparison between age groups.

Design/Methods DESIGN/METHODS: All records of CNIII palsy in our data base between 1995 and 2012 were reviewed.

Results RESULTS: 481 charts were reviewed; 234 episodes met inclusion criteria. Age of onset ranged from birth-92 years with 80% being 50+. Microvascular etiology represented 53% of cases and was most prevalent in the 50+ age group with the highest rate of full recovery >90% with sufficient follow-up. Trauma represented 10%, and neoplasm represented 9% of cases. Trauma and neoplasm full recovery rates were 40-50% with sufficient follow-up. Brainstem stroke accounted for 6% overall and 33% of sufficiently followed cases had full recovery. Aneurysm accounted for 5%, infection for 2% and idiopathic cases for 7%. Of all cases with sufficient follow-up, 44% fully recovered, 9% had partially recovered, and 4% had no recovery; 43% had insufficient follow-up or only one visit.

Conclusions CONCLUSIONS: This MRI era study shows a higher incidence of microvascular than neoplastic and traumatic etiology compared to pre-MRI era studies. Similar to pre-MRI studies, traumatic and neoplastic etiologies were most prevalent in the less than 18 age group with comparable recovery rates. Microvascular etiology was most prevalent in the over 50 age group, and in those cases with sufficient follow-up >90% recovered fully as suggested in older studies. This study demonstrates that etiology depends on age, but prognosis depends on etiology.

Authors/Disclosures
Edward J. Atkins, MD (Dr. Edward J. Atkins) PRESENTER	No disclosure on file
Ricarda Bentham	No disclosure on file
	No disclosure on file
Kevin M. Biglan, MD (Eli Lilly)	Dr. Biglan has received personal compensation for serving as an employee of Eli Lilly. Dr. Biglan has received stock or an ownership interest from Eli Lilly.

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