The authors used the Rochester Epidemiology Project for this retrospective case review of third nerve palsy. Inclusion criteria was adults >18 years, with new onset isolated microvascular third nerve palsy diagnosed within a 36-month period, with recovery or significant improvement, without aberrant regeneration. Cardiovascular risk factors were investigated. A control group was also selected from the same database, matched by age and sex. Risk factors were reviewed against controls. A total of 55 individuals diagnosed with an isolated third nerve palsy were identified. The annual incidence of 1.7 per 100,000 was calculated. The presence of the following were significantly higher in the group diagnosed with third nerve palsy vs. age and sex matched controls; hypertension, diabetes, diabetic retinopathy, coronary artery disease and ischemic stroke. A higher 10-year mortality was also found in individuals diagnosed with third nerve palsy vs. controls (49% vs. 30%), but this was not statistically significant. The authors acknowledge the limitations of the area covered by the database which was predominantly white and the small sample size. It is clear from this study that diabetes and hypertension should be a focus for investigation following the diagnosis of an isolated microvascular third nerve palsy with the purpose of secondary prevention.
The risk factors associated with isolated microvascular third nerve palsy
Reviewed by Lauren Hepworth
Vascular risk factors in isolated microvascular ischemic third nerve palsy: a population based study.
CONTRIBUTOR
Lauren R Hepworth
University of Liverpool; Honorary Stroke Specialist Clinical Orthoptist, Northern Care Alliance NHS Foundation Trust; St Helen’s and Knowsley NHS Foundation Trust, UK.
View Full Profile
