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Case Reports
. 2016 May;64(5):397-8.
doi: 10.4103/0301-4738.185628.

Congenital third nerve palsy with synergistic depression on attempted adduction and trigemino-oculomotor synkinesis: Underpinnings of a spectral dysinnervation disorder

Pramod Kumar Pandey  1 , Vishaal Bhambhwani  1 , P C Ranjith  1 , Mandar Kadav  1 , C Aparnaa  1
Affiliations
Case Reports

Congenital third nerve palsy with synergistic depression on attempted adduction and trigemino-oculomotor synkinesis: Underpinnings of a spectral dysinnervation disorder

Pramod Kumar Pandey et al. Indian J Ophthalmol. 2016 May.

Abstract

The authors describe a case of congenital partial pupil-sparing third cranial nerve palsy with absent adduction, synergistic depression of globe and widening of palpebral fissure on attempted adduction and synergistic elevation and adduction on mouth opening and sideways thrusting of jaw. The case illustrates trigemino-oculomotor synkinesis associated with congenital third nerve palsy. The possible mechanism of miswiring involving the medial longitudinal fasciculus and trigeminal nuclei is discussed. At least some cases of congenital third cranial nerve palsy may fall in the realm of congenital cranial dysinnervation disorders (CCDDs) sharing a much wider spectrum of presentation.

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Figures

Figure 1
Figure 1
(a) Anomalous head posture with face turn to the left and chin elevation, fixing OD. (b) Versions demonstrating large exotropia OD (fixing OS), with absent adduction OD, limited elevation and depression OD, synergistic depression and widening of palpebral aperture on attempted adduction OD
See this image and copyright information in PMC

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