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مقاله
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Abstract
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Title:
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Isolated left third cranial nerve palsy
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Author(s):
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Esmaeil Rezaeian
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Presentation Type:
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Poster
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Subject:
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Strabismus & Neuro-ophthalmology
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Others:
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Presenting Author:
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Name:
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Esmaeil Rezaeian
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Affiliation :(optional)
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E mail:
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dr.rezaeian@gmail.com
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Phone:
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08652340501
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Mobile:
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09123575311
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Purpose:
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case report
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Methods:
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observatioal study - case report
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Results:
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A 46-year-old man presented with sudden onset of frontal headache associated with left ptosis and diplopia without any eye pain or blurring of vision. He has history of diabetes mellitus and hypertension no any history of fever, URTI, cough, fits, earache, nausea and vomiting. No focal or generalized limb weakness, no speech or auditory disturbances.
No reverse RAPD, good red reflex in both eyes but there was evidence of anisocoria (right pupil 2 mm vs. left pupil 5 mm), left ptosis and present of double vision in all gazes, there were evidence of limitation in left extraocular movement in the elevation, depression and adduction positions. funduscopy showed mild NPDR.
CT scan and MRI of brain showed sellar round heterogenously hyperintense T1 and T2 enhancing lesion with minimal peripheral enhancement.
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Conclusion:
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Isolated third nerve palsy involving the pupil is a rare presentation of craniopharyngioma and requires urgent evaluation, which can be the only sign and it might be partial insist of complete third nerve palsy. The differential diagnosis of a third nerve palsy includes aneurysm, neuromuscular disease, orbital and cavernous sinus lesions, chronic meningitis and midbrain pathology, which can miss easily.
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Attachment:
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595third nerve.pptx
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