The clinical and etiological study of the Oculomotor nerve palsy in a rural hospital

Most of the times the oculomotor palsies are referred to an ophthalmologist from various other specialities, as they are often perceived as a sign of serious underlying pathology, like a compression of the oculomotor nerve resulting from an expanding aneurysm at the junction of internal carotid and posterior communicating arteries, one of the few emergency situation in neuro-ophthalmology, so every case has to be evaluated and its probable etiology identified. This study is done in a rural hospital emphasizing the need to identify the cause of the third nerve palsy for its early management.

The study was conducted in the Department of Ophthalmology, Adichunchanagiri Institute of Medical Science, B.G. Nagara, Mandya district, Karnataka, from November 2013 to July 2015. Thirty five cases of oculomotor nerve paralysis, presenting themselves directly to the ophthalmology outpatient department or referred from various other departments were studied and analysed.

Isolated oculomotor nerve palsy was observed in 74.28% and multiple cranial nerve palsy was observed in 25.17%. Microvascular ischemia 40% as an etiology was found as the predominant cause, which showed a good prognosis for the complete recovery in 31.42% cases.

Predominant mode of presentation was isolated oculomotor nerve palsy, with microangiopathy as the major etiological factor, which has a good prognosis for complete recovery.