Isolated unilateral oculomotor paresis in pure midbrain stroke

Journal of the Neurological Sciences
Yu AmanoKen Johkura

Abstract

Pure midbrain stroke can cause isolated unilateral oculomotor paresis. We attempted to determine whether there is a difference in the oculomotor paresis pattern between pure midbrain infarction and midbrain hemorrhage. Pure midbrain stroke patients who presented with isolated unilateral oculomotor paresis were identified from a group of 2447 consecutive patients hospitalized for acute cerebral infarction or hemorrhage during the period May 2008 through April 2014. Detailed oculomotor findings were evaluated in the identified patients per the cause of the stroke. Five patients with infarct and 1 with hemorrhage became our study subjects. Lesions were located in the paramedian area of the midbrain involving the oculomotor fascicles. The pupillary sphincter and inferior rectus muscles were selectively spared in the infarct patients, whereas these muscles were selectively affected in the hemorrhage patient. Fibers in the oculomotor fascicle that innervate the levator palpebrae, superior rectus, and inferior oblique muscles appear to be more susceptible to ischemic damage than those that innervate the pupillary sphincter and inferior rectus muscles. Isolated impairment of the pupillary sphincter and inferior rectus muscles may be su...Continue Reading

References

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Citations

Aug 25, 2015·Journal of the Neurological Sciences·Renjing ZhuWeihong Zheng
Apr 14, 2016·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Katsuhiko OgawaHiroshi Ishikawa
Jan 4, 2017·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Lilei PengLigang Chen
Jul 10, 2020·Rinshō shinkeigaku = Clinical neurology·Yuki NakamuraShun Shimohama
Nov 25, 2020·Rinshō shinkeigaku = Clinical neurology·Tatsuya MukaiTakehisa Araki

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