My patient having history of non explored peripheral neuropathy and now she is presenting a third nerve palsy with mydriasis
Dear Dr kchida.
This complication is not common in SLE, and you discuss possible aetiologies including ischemia, demyelination, neuromuscular conditions and medication-induced....myasthenia ..
Thank you Dr Houman for your answer, a preliminary reading of the MRI showed demyelinating lesions. ANA are positifs 1/400 with a speckled aspect., we don't have the result of screening yet. No signs of multiple sclerosis according to the neurologists.
Clinically, the first question would be whether there is a relation between peripheral neuropathy and oculomotor nerve palsy. It would be important to know whether neuropathy in evolving rapidly or is a more chronic condition. So at first, diabetes mellitus, as common cause of both, should be considered. Second, especially when mydriasis is present, compressive lesions habe to be ruled out (i.e. aneurysm, tumor...). Was the third nerve palsy painless?
If ataxia due to PNP is present, Millef-Fisher-Syndrom merits to be considered, too.
Hope I was helpful.
Deare DR Ulbricht m'y patient had an acute third nerve palsy. She has no diabetes. MRI ruled out any compressive tumor and her nerve palsy was painless and no ataxia. Thank you for your answer
- Badges
- Science topic
- Similar topics
- Chemistry
- Pharmacology
- Medical Pharmacology
- Clinical Pharmacology