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Background: Oculomotor nerve paresis may have relatively benign but also life -threatening causes. Distinguishing between these is of great clinical importan ce. Objective: To reveal a potential pitfall of the clinical evaluation of oculo motor nerve paresis. Patient: Single case observation. Results: A 56-year-old man had fluctuating diplopia and fatigable ptosis, promptly relieved by intraven ous edrophonium, leading to the diagnosis of ocular myasthenia gravis. His pupil lary function was intact. A few days after the initial diagnosis, he suffered a subarachnoid hemorrhage secondary to the rupture of a basilar artery aneurysm. H is ocular symptoms were related to aneurysmal oculomotor nerve compression. Conc lusion: Patients with oculomotor nerve dysfunction need more detailed evaluation because the underlying cause cannot be safely determined on a clinical basis.
Background: Oculomotor nerve paresis may have relatively benign but also life -threatening causes. Distinguishing between these is of great clinical importan ce. Objective: To reveal a potential pitfall of the clinical evaluation of oculo motor nerve paresis. Patient: Single case observation. : A 56-year-old man had fluctuating diplopia and fatigable ptosis, promptly relieved by intravenous ous edrophonium, leading to the diagnosis of ocular myasthenia gravis. A few days after the initial diagnosis, he suffered a subarachnoid hemorrhage secondary to the rupture of a basilar artery aneurysm. H is ocular symptoms were related to aneurysmal oculomotor nerve compression. Conc lusion: Patients with oculomotor nerve dysfunction need more more evaluation because the underlying cause can not be safely determined on a clinical basis.