Third nerve palsy

Third nerve palsy is one of the terms that make it difficult to understand. Yes. Don’t get panic of this term. This denotes the third cranial nerve problem and more precisely means the palsy in third nerve.


In persons with third nerve palsy, the associated conditions need to be essentially ruled out because these conditions also often lead to the development of similar signs in the affected persons.

For example, the diabetes or strabismus may add to this problem in addition to the increased blood pressure in the concerned individual. Hence, in case of third nerve palsy, one needs to be careful in maintaining the normal blood pressure.

Eyelids in the third nerve palsy conditions often become droopy thus reducing the double vision, which is so characteristic of the third nerve palsy in general.

In these conditions the characteristic feature is the failure of eyes to move in all directions of gaze. There will be loss of upward or downward or medial movement of the eyes in the affected persons with palsy in the third cranial nerve.

In these conditions, often the glasses may not be of helpful in the rectification of the defect. Often there will be a sudden onset of double vision in the affected persons. There may be even a significant amount of pain in the affected persons. The ophthalmologists need advanced techniques to diagnose properly this eye-based nerve-problem.

One may be wondering on what has happened to the eyes. Neurological imaging is the one that is required in order to find an in depth study of the pupillary involvement in the eyes of the affected persons.

If you lift the eyes, there will be often a divergent type of strabismus and also a non-reactive pupil, which is in the dilated status. Epidermoid cyst, metastaic growth causing problems, meningitis, encephalitis etc. also need to be ruled out which cause more or less similar kind of signs.

Ischemic vascular disorders or damage to the oculomotor nerve may lead to the development of this condition and the point anywhere between the origin and insertion may get affected due to multifaceted etiological agents.

Headache and the presence of double vision are the general symptoms that can be expected during occurrence of the arterial aneurysm based symptoms. However, since this is a natural phenomenon due to multiple factors; the remedial measures are difficult in general.

Pressure causing lesions anywhere in the tract of this nerve are the commonly encountered problems that cause third nerve palsy. Aneurysm of posterior communicating artery can cause such third nerve palsy in case of aged persons.

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