C/o head ach , drowsiness, since 4days later he developed suddenly drooping of left upper lid mid dilated pupil , decreased vision ...Rx dx

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Complete 3rd nerve palsy, painful, with visual (optic n) impairment, orbital pseudo tumor most likely, NSAID + steroids. Exclude SAH / aneurysm

Patient has complete ptosis in left eye which indicates LPS Muscle Paresis, after manual retraction of left upper lid eyeball cannot maintain the primary position of gaze and is rotated laterally which indicates medial rectus paresis(may be the cause of decreased vision due to lack of convergence reflex), pupil is mid dilated which indicates sphincter pupillae Paresis indicates complete 3rd Nerve Palsy, now patient also complains Headache and Drowsiness so there must be some neurological lesion(eg PCA Aneurysm) which is hampering 3rd Nerve Nucleus.MRI Brain should be done.

Acute Left 3rd c.n. palsy , Mri brain, blood investigations routeine, lipid profile, rule out diabetes, hypertension, smoking history , drug history, migraine history, Since painful, could be Aneurysmal compression of 3rd n. Meanwhile start steroids, nsaids, neurotrophic vitamins injectable. Refer to neurologist...

3rd n palsy examine BP ,blood sugar MRI brain &orbit systemic wysolone 1mg /kg 3days start tapering with omiperzole ,B1,6,12 .Neurological opinion

Left complete 3rd Nerve palsy. Suggest Mri brain with MRA. Further management afyer MRI

3rd N palsy, complete ophthalmological examination Complete baseline blood investigations MRI brain to locate any intracranial cause

It is oculomotor nv palsy Check up of blood sugar level and advise MRI

3rd CR. n. Palsy : Adv : * Neurologist 's opinion . * MRI brain . Systemic steroid & oral nsaid . Vit- b 1+ b6+ b12.

Complete Lt 3rd Nv Palsy,MRI brain suggested

Thanks Dr Raja kumar
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What about extraocular movement 2,3 nerve involved rest can't comment High possibility of SOL Get brain scan

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