Isolated oculomotor nerve palsy due to mesencephalic infarction diagnosed by ZOOM DWI

Abstract Background Oculomotor nerve palsy is a common neurological presentation in daily practice. Case presentation A 55-year-old man presented with a 3-h history of diplopia and drooping of his bilateral especially left eyelids. Examination revealed an isolated oculomotor nerve palsy consisting o...

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Main Authors: Shangpei Wang, Yajie Cai, Xiaosan Wu, Sunhong Yan, Longsheng Wang
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Neurology
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Online Access:https://doi.org/10.1186/s12883-025-04021-x
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author Shangpei Wang
Yajie Cai
Xiaosan Wu
Sunhong Yan
Longsheng Wang
author_facet Shangpei Wang
Yajie Cai
Xiaosan Wu
Sunhong Yan
Longsheng Wang
author_sort Shangpei Wang
collection DOAJ
description Abstract Background Oculomotor nerve palsy is a common neurological presentation in daily practice. Case presentation A 55-year-old man presented with a 3-h history of diplopia and drooping of his bilateral especially left eyelids. Examination revealed an isolated oculomotor nerve palsy consisting of left medial rectus, inferior oblique, superior rectus, inferior rectus with intact pupillary reflexes and bilateral especially left superior palpebral levator. Conventional diffusion weighted imaging (DWI) of the brain showed a suspicious restriction in the left midbrain periaqueductal region. If the clinical symptomatology indicates a lesion in the midbrain, of which a high signal intensity was encountered from neurologically healthy older adults, the limited spatial resolution of conventional axial DWI is an enormous disadvantage. Zonally magnified oblique multislice (ZOOM) DWI correlated with apparent diffusion coefficient map providing higher accuracy for accurate diagnosis can identify signal alterations of mesencephalic interpeduncle area. Conclusions This is a rare presentation of isolated oculomotor nerve palsy due to pure mesencephalic infarction especially verified by ZOOM DWI.
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institution Kabale University
issn 1471-2377
language English
publishDate 2025-02-01
publisher BMC
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series BMC Neurology
spelling doaj-art-db4bc12b426a4fbc9f94e2c72b5d4d802025-02-09T12:43:05ZengBMCBMC Neurology1471-23772025-02-012511410.1186/s12883-025-04021-xIsolated oculomotor nerve palsy due to mesencephalic infarction diagnosed by ZOOM DWIShangpei Wang0Yajie Cai1Xiaosan Wu2Sunhong Yan3Longsheng Wang4Department of Radiology, the Second Affiliated Hospital of Anhui Medical UniversityDepartment of Radiology, the Second Affiliated Hospital of Anhui Medical UniversityDepartment of Neurology, the Second Affiliated Hospital of Anhui Medical UniversityDepartment of Neurology, the Second Affiliated Hospital of Anhui Medical UniversityDepartment of Radiology, the Second Affiliated Hospital of Anhui Medical UniversityAbstract Background Oculomotor nerve palsy is a common neurological presentation in daily practice. Case presentation A 55-year-old man presented with a 3-h history of diplopia and drooping of his bilateral especially left eyelids. Examination revealed an isolated oculomotor nerve palsy consisting of left medial rectus, inferior oblique, superior rectus, inferior rectus with intact pupillary reflexes and bilateral especially left superior palpebral levator. Conventional diffusion weighted imaging (DWI) of the brain showed a suspicious restriction in the left midbrain periaqueductal region. If the clinical symptomatology indicates a lesion in the midbrain, of which a high signal intensity was encountered from neurologically healthy older adults, the limited spatial resolution of conventional axial DWI is an enormous disadvantage. Zonally magnified oblique multislice (ZOOM) DWI correlated with apparent diffusion coefficient map providing higher accuracy for accurate diagnosis can identify signal alterations of mesencephalic interpeduncle area. Conclusions This is a rare presentation of isolated oculomotor nerve palsy due to pure mesencephalic infarction especially verified by ZOOM DWI.https://doi.org/10.1186/s12883-025-04021-xOculomotor nerve palsyMesencephalic infarctionZOOM DWI
spellingShingle Shangpei Wang
Yajie Cai
Xiaosan Wu
Sunhong Yan
Longsheng Wang
Isolated oculomotor nerve palsy due to mesencephalic infarction diagnosed by ZOOM DWI
BMC Neurology
Oculomotor nerve palsy
Mesencephalic infarction
ZOOM DWI
title Isolated oculomotor nerve palsy due to mesencephalic infarction diagnosed by ZOOM DWI
title_full Isolated oculomotor nerve palsy due to mesencephalic infarction diagnosed by ZOOM DWI
title_fullStr Isolated oculomotor nerve palsy due to mesencephalic infarction diagnosed by ZOOM DWI
title_full_unstemmed Isolated oculomotor nerve palsy due to mesencephalic infarction diagnosed by ZOOM DWI
title_short Isolated oculomotor nerve palsy due to mesencephalic infarction diagnosed by ZOOM DWI
title_sort isolated oculomotor nerve palsy due to mesencephalic infarction diagnosed by zoom dwi
topic Oculomotor nerve palsy
Mesencephalic infarction
ZOOM DWI
url https://doi.org/10.1186/s12883-025-04021-x
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AT xiaosanwu isolatedoculomotornervepalsyduetomesencephalicinfarctiondiagnosedbyzoomdwi
AT sunhongyan isolatedoculomotornervepalsyduetomesencephalicinfarctiondiagnosedbyzoomdwi
AT longshengwang isolatedoculomotornervepalsyduetomesencephalicinfarctiondiagnosedbyzoomdwi