A 48-year-old man with ptosis and limitation of elevation in the left eye © 2014 American Academy of Neurology Teaching NeuroImages Neurology Resident.

Slides:

Advertisements

Similar presentations

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology Neonatal Parechovirus Encephalitis: Typical MRI findings.

Advertisements

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 68 year old woman with transient ptosis on awakening.

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology Intracranial mass presenting with hemorrhage and respiratory.

A 56-year-old man with intense facial pain Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

A 52-year old man with recently diagnosed HIV infection with irregular shaking of his hand Teaching NeuroImages Neurology Resident and Fellow Section ©

A 62-year-old man presented with mild left hemiparesis, headache and blurred vision of his right eye Teaching NeuroImages Neurology Resident and Fellow.

A TWO YEAR OLD GIRL WITH PROGRESSIVE WEAKNESS Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

A 62-year-old man with progressive action tremor and a 74-year-old man with progressive ataxia Teaching NeuroImages Neurology Resident and Fellow Section.

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 51-year-old woman with triplegia and blindness.

Teaching NeuroImages Neurology Resident and Fellow Section A 57-year-old woman with blurred vision © 2014 American Academy of Neurology.

55-year-old man with progressive dementia Teaching NeuroImages Neurology Resident and Fellow Section.

Acute neck pain and quadriparesis An 82 year old man with acute neck pain Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy.

48-year-old man with ascending sensory deficits Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

contains axons that arise in the  oculomotor nucleus (which innervates all of the oculomotor muscles except the superior oblique and lateral rectus)

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 64-year-old man with right facial pain and spasms.

A 59 year old man with sudden inability to move his left foot Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

A 68 year old woman with a troublesome chin tremor Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

84 year old woman with spells of right upper limb weakness and numbness Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy.

A patient with red dot on the forehead A 32-year old woman presented with red dot on her forehead and eyelid ecchymosis Teaching NeuroImages Neurology.

Teaching NeuroImages A Woman with Atypical Facial Pain Neurology Resident and Fellow Section.

Teaching NeuroImages An 83-year-old woman with phonatory breaks and left hand rest tremor Neurology Resident and Fellow Section © 2013 American Academy.

A 30 year old man with sub-acute ataxia Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

Neurology Resident and Fellow Section 40 year old woman with left arm pain, numbness, and weakness Teaching NeuroImages © 2013 American Academy of Neurology.

A 43-year-old man with decreased consciousness Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 35-year-old woman with headache and diplopia.

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 54 year old man with progressive apathy and cognitive.

A 50 year old man with progressive tetraparesis and blindness Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

A 38-year-old patient with partial seizures Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

A 53-year-old man with abrupt hearing loss Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A dangerous case of orthostatic headache.

47-year-old with progressive upper limb weakness Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology An unusual cause of conus medullaris syndrome.

A 30-year male with cognitive decline and unsteady gait Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

Teaching NeuroImages 50 year old woman underwent therapeutic hypothermia after a witnessed cardiac arrest Teaching NeuroImages Neurology Resident and Fellow.

A 39-year old man with facial diplegia Teaching NeuroImages Neurology Resident and Fellow Section Campbell J, et al © 2013 American Academy of Neurology.

© 2013 American Academy of Neurology Teaching NeuroImages Neurology Resident and Fellow Section A 61-year-old patient with subacute blindness on the left.

68 year old man with aphasia and facial droop © 2014 American Academy of Neurology Teaching NeuroImages Neurology Resident and Fellow Section.

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology A 32-year-old man with a neuroendocrine disorder.

A 22 years old man with slow movements and mounding phenomenon © 2013 American Academy of Neurology Teaching NeuroImages Neurology Resident and Fellow.

Third nerve palsy To Vichhey. Outline Review anatomy Introduction Physiopathology Symptom and sign Etiology Differential diagnosis Work up Treatment.

A 26 year old woman with headache, diplopia, and pulsatile tinnitus Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy.

40 year old male with shooting type of pain in the lower leg Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology A 67 year-old man with progressive facial diplegia and.

A 21-year-old male with rapidly- progressive cortical visual loss Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of.

A 45 year old man with painful right eye blindness Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

A 4 Year Old Boy With Proptosis of Left Eye Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

6-year-old boy with progressive neurologic decline Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology.

52yo male with multiple lower cranial neuropathies Teaching NeuroImages Neurology Resident and Fellow Section by Nathaniel M. Schuster, Stellios Karnezis,

23 yo man with left buttock pain Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

A 71 year old man with rapid onset of anterograde amnesia Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology A two month old male infant presented with macrocephaly.

An (un)usual case of leg pain? Teaching NeuroImage Neurology Resident and Fellow Section © 2014 American Academy of Neurology.

“Now you see it...” A broadly-distributed ictal rhythm easily missed on bipolar montage. Teaching NeuroImages Neurology Resident and Fellow Section © 2014.

Teaching NeuroImages Neurology Resident and Fellow Section A 51 year old female with intermittent left hand numbness and weakness. © 2013 American Academy.

57 year-old man with confusion Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section Spherules in Spine: Vertebral Coccidioidomycosis © 2014 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology MRI-visible Virchow-Robin Perivascular Spaces in Cerebral.

Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology Two sisters with scapular winging.

A 36 year old woman with diplopia Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology.

A 35-year-old patient with motor aphasia Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology 57-year-old man with a painful tumoral mass in the leg.

Deschamps et al. TEACHING NEUROIMAGES NEUROLOGY RESIDENT AND FELLOW SECTION A 54-year-old man with eyelid swelling and diplopia.

Patient with painful ophthalmoplegia after traffic accidents

A 63-year-old man with transient vertical diplopia

A 29-year-old HIV infected man with right eye-lid ptosis and diplopia

68-year-old patient with memory impairment

Neurology Resident and Fellow Section

A 56 YEAR OLD MAN WITH TRANSIENT VISUAL LOSS

Acute bilateral ptosis in an 82-year old man

Presentation transcript:

A 48-year-old man with ptosis and limitation of elevation in the left eye © 2014 American Academy of Neurology Teaching NeuroImages Neurology Resident and Fellow Section

Vignette A 48-year-old man presented with ptosis in the left eye for 2 months. He denied ocular pain, diplopia, visual loss, or diurnal fluctuation. Neurologic examination showed incomplete ptosis and limitation of elevation with normal pupil in the left eye. Park et al. © 2014 American Academy of Neurology

Imaging © 2014 American Academy of Neurology Park et al.

Divisional patterns of oculomotor nerve palsy usually indicate a lesion involving the oculomotor nerve distal to anterior cavernous sinus where the nerve divides into the superior and inferior branches. In this patient, the ptosis and limitation of elevation in the left eye indicate a lesion limited to the oculomotor superior division that innervates the levator palpebrae and superior rectus. Orbital lesions including lymphoma should be considered in divisional patterns of oculomotor palsy. Superior Divisional Oculomotor Nerve Palsy due to Orbital Lymphoma © 2014 American Academy of Neurology Park et al.