Dr.savithiri palanivel, P20351
Oculomotor palsy is one of the common situation encountered in the neurophthalmic outpatient department. It has myriad causes from vasculopathic to aneurysmal. Here we present one such extreme cause of an isolated 3rd nerve palsy. A 75 year old gentle man presented to us with isolated painful 3rd nerve palsy with a history of diabetes and hypertension, his BCVA was 6/6 in both eye. Painful 3rd nerve palsy, old age, raised ESR and positive CRP and normal MRI and MRA brain lead to diagnosis of GCA which was confirmed by neurologist and treatment was started. Persistence of pain and 3rd nerve palsy, alarmed us to investigate further with contrast imaging. To our surprise a nasopharyngeal mass was detected which is causing a 3rd nerve palsy. Here we present a Nasopharyngeal mass presented to us as a 3rd nerve palsy as the only neurophthalmic feature without any local symptoms of malignancy.
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