Oculomotor Neuropathy
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0486-Oculomotor Neuropathy
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CA0486-Oculomotor Neuropathy
Case ReportHistory
Exam
Prior Study
Findings
Brain and Brainstem
The region of the third cranial nerve nucleus, site of the median longitudinal fasciculus at the level of the 3rd nerve nucleus and the respective 3rd nerve tract within the brainstem to the 3rd nerve root entry zone is abnormal on the FLAIR images and DWI images including the ADC map indicating likely brainstem infarction in those areas. There are linear areas of increased signal intensity not typical of MS in the anterior periventricular deep white matter.
General Meninges, Cisternal Segment and Root Entry Zone
Generalized abnormal meningeal (dural and/or pia-arachnoid) enhancement is not present. However, the pia/arachnoid surface at the root exit zone of the third nerve enhances abnormally. There is minimal abnormal enhancement the cisternal segment of the third cranial nerve.
There is no posterior communicating or other cerebral aneurysm along the cisternal segment of the third, fourth and/or sixth cranial nerve.
Cavernous sinus and Paracavernous Structures and Central Skull Base
There is no abnormal enhancement and/or enlargement or structural abnormality of the 3rd, 4th or 6th cranial nerve along their courses in the cavernous sinus or paracavernous region.
Orbit, Extraocular Muscles, Sinonasal Region and Related Skull Base
The orbital apex and superior orbital fissure appear normal. The extraocular muscles appear normal. The intraconal and/or extraconal orbital fat appears normal.
There is no pathologic process arising within the orbit, sinonasal structures or skull base that might produce secondary loss of normal ocular motility or vision by involving extraocular muscles.
