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Middle East African Journal of Ophthalmology Middle East African Journal of Ophthalmology
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CASE REPORT
Year : 2012  |  Volume : 19  |  Issue : 2  |  Page : 237-239

Pupil-sparing complete third nerve palsy from cryptogenic midbrain stroke in an otherwise-healthy young adult with patent foramen ovale


Division of Pediatric Ophthalmology and Strabismus, King Khaled Eye Specialist Hospital, Riyadh, Kingom of Saudi Arabia

Correspondence Address:
Arif O Khan
Division of Pediatric Ophthalmology & Strabismus, King Khaled Eye Specialist Hospital, PO Box 7191, Riyadh 11462
Kingom of Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-9233.95260

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Although pupil-sparing in acute unilateral complete third nerve palsy is often a sign of ischemic nerve injury, it is not specific for injury outside of the midbrain. This report documents acute pupil-sparing complete third nerve palsy in an otherwise healthy young adult with patent foramen ovale and associated atrial dilatation who suffered cryptogenic focal midbrain stroke, presumably from a paradoxical embolism. The patent foramen ovale was surgically closed. Over the next several months neurological recovery was complete except for diplopia and relatively comitant hypotropia, which responded well to conventional strabismus surgery.


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