Tayyaba Gul Malik, Khalid Farooq, Muhammad Khalil.
Neuro-imaging Patterns of Isolated Ocular Motor Nerve Palsies in a Pakistani Cohort.
Ophthalmol Update Jan ;13(2):52-5.

Objective: To determine neuro-imaging patterns of ocular motor nerve palsies in a Pakistani cohort and to compare with other populations. Study Design: Descriptive, retrospective study. Study period: 2010 to 2014 Subjects and settings: 50 Patients of ocular motor nerve palsies from two different centers of Lahore were included in the study. History charts and neuro-imaging reports were reviewed. The data considered for the study was age, sex, ocular manifestations, neuro-ophthalmological findings and imaging reports (CT scans, MRI, MRA and MRV). Results: Female to male ratio was 1.6:1. Age ranged from 13 years to 74 years (average 44.18). 66% (n=33) patients had isolated sixth nerve palsy and 34% (n= 17) had isolated third nerve palsy. None of our patients had fourth nerve palsy. 42% patients had normal neuro-imaging. Sinusitis and brain infarcts were commonest cause of third nerve palsy while demyelination was more common in patients with sixth nerve palsy. Other neuro-etiologies were space-occupying lesions, parasellar tumours, multiple sclerosis, aneurysm and meningitis. Conclusion: Third nerve palsy is the commonest ocular motor nerve palsy. There are certain cases where neuro-imaging shows normal scans and the cause of palsy remains undetermined.

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