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45 years old patient with palpebral ptosis and headaches. (General Medicine)

Dr. Aida Quka., FACULTY OF MEDICINE, UNIVERSITY OF TIRANA, NEUROLOGY POST GRADUATION DEGREE, UNIVERSITY HOSPITAL CENTER

 

Medical Case Details:

The patient complaints of headaches in the frontal region from 15 days, with blurring vision in the right eye, right palpebral ptosis.

There is nonreactive midriasis in the right eye. Brain CT scan and MRI normal. No other symptoms.

 


    Discussions


    Dr. Sheetal Kamble

    Have you checked his sugar levels? I had seen few diabetic patients with similar symptoms.
    Also it can be mere occular migraine.

    ▲ 1
    17.Dec, 01:52am

    Dr. Guillaume J Lamotte
    Neurologist

    Hello,

    The symptoms are very concerning for a third nerve palsy with ptosis and mydriasis. Any oculomotor abnormality? Patient needs vessel imaging (i.e. MRA or CTA) to rule out compressive etiology such as PiCOM aneurysm if he has a third nerve palsy with pupil involvement. Other causes of third nerve palsy (i.e. microvascular in setting of diabetes, etc...) should be investigated if he does have a third nerve palsy.

    Sincerely

    ▲ 1
    03.Jan, 05:35am

    Dr. Aida Quka
    Neurologist

    Thanks for the suggestion. It true that it is third cranial nerve palsy. brain CTA and MRI are normal.

    Steroid therapy helped improve the situation.

    Kind regards!

    ▲ 1
    03.Jan, 03:30pm

    Dr. Mohammad Asran

    Trigeminal nueralgia.

    ▲ 1
    27.Jul, 04:44pm



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