Evaluating Patients with Potential Third Nerve Palsy

In this 1-Minute video, Dr. Vivek Patel offers tips on evaluating a patient with a potential third nerve palsy. Any patient who exhibits partial deficits of adduction, supraduction or infraduction of the eye, along with ptosis, should be evaluated as if they are progressing toward a complete third nerve palsy. Imaging (e.g., CTA or MRA) should be performed immediately in such cases, even if the pupil is not involved at the time of evaluation. Children should undergo MRI with and without contrast, as well as MRA, to detect any soft-tissue lesions of the brain parenchyma. It may be possible to delay imaging in adult patients who have vasculopathic risk factors and a complete, pupil-sparing third nerve palsy that is no longer evolving.

View other 1-Minute Videos from Dr. Patel:
What To Do When You Suspect Giant Cell Arteritis

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