Management of Traumatic Isolated Unilateral Oculomotor Nerve Palsy in the Emergency Department and Literature Review

Abstract

Cranial nerve (CN) lesions are observed due to congenital, infectious, neoplastic formations, migraine and head trauma. Along with the patient's age, clinical findings and neuroradiological imaging studies guide the diagnosis. A 57-year-old female patient was brought to the emergency room (ER) by Emergency Medical Services (EMS) due to a motor vehicle accident. No medical history. She was conscious, cooperative and orientated. Vital findings were normal. She had ptosis in the left eye, loss in the direct light reflex, restricted medial movements and mydriasis were determined. Radiological examination is normal. The patient was hospitalized with the diagnosis of isolated 3rd cranial nerve palsy (OCNP). Isolated OCNP is a rare condition usually secondary to major trauma. In addition to, there may be isolated unilateral OCNP without any evidence of neuroimaging abnormality. Emergency physicians should be vigilant in such cases that should perform detailed neurological examination and clinical follow-up for the patient's complaints.

Keywords

• acil servis
• i̇zole okülomotor sinir felci
• midriyazis
• minör kafa travması
• emergency department
• isolated oculomotor nerve palsy
• minor head trauma
• mydriasis