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Headache preceded the onset of a third nerve paralysis by up to 11 days.
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Of these cases, 41% had a third nerve palsy.
Also supporting this model is the finding that initial AChR clustering is independent of neuronal agrin (Lin et al., 2001; Yang et al., 2001) and that rudimentary NMJs form in agrin-deficient mice (Gautam et al., 1996), which suggested the existence of a second nerve derived organizing signal.
They concluded that an intrinsic transient abnormality in the cisternal segment of the third nerve had a pathophysiologic mechanism in patients with a typical clinical presentation of ophthalmoplegic migraine.
Within the paediatric age group, acute benign sixth nerve palsy accounts for 9-14% of all sixth nerve palsies [ 2].
One patient reported persistent diplopia, which was due to decompensation of a long-standing third nerve palsy.
To evaluate whether multidetector computed tomographic angiography (CTA) scanners can detect a clinically significant intracranial aneurysm in the circle of Willis causing an isolated third nerve palsy (ITNP).
Both post resolution MRIs demonstrated decrease in enhancement and thickening of the third nerve.
After 9 months of observation, the function of the third nerve recovered except for the ciliary branch.
They speculated that the contact between the third nerve and the dilated intracranial artery could episodically produce a migrainous syndrome sustained by activation of the trigeminovascular system as well as compression and paralysis of the third nerve.
More recently, the hypothesis of a demyelinating mechanism affecting the oculomotor nerves has been put forward, following the demonstration by imaging of swelling and enhancement of the intracisternal portion of the third nerve.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com