SAQ 986 – Third cranial nerve palsy and anisocoria

A 35-year-old woman presents with diplopia. She has binocular double vision on horizontal and vertical gaze, and you suspect a third cranial nerve palsy.

Describe the typical examination findings of a third nerve palsy.

(Marked out of 3.0)

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Complete the table linking lesion location with associated symptoms or signs.

(Marked out of 6.0)
</p> <table class="saq-prop-table" style="width: 100%; max-width: 100%; table-layout: fixed; border-collapse: collapse;"> <thead> <tr> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Location of lesion</th> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Associated symptoms/signs</th> </tr> </thead> <tbody> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Brainstem/midbrain</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Intracranial course</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Orbital/superior orbital fissure/orbital apex</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> </tbody> </table> <p>

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Explain why ipsilateral pupil dilation helps distinguish compressive from microvascular/ischaemic aetiology in third nerve palsy.

(Marked out of 2.0)

/ 2

List five causes of anisocoria other than third nerve palsy.

(Marked out of 5.0)

/ 5

Total Score: 0 / 16

Percentage: 0%