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September 1979

Primary Aberrant Oculomotor Regeneration due to Intracranial Aneurysm

Author Affiliations

From the Department of Ophthalmology, University of Kansas Medical Center, Kansas City.

Arch Neurol. 1979;36(9):570-571. doi:10.1001/archneur.1979.00500450064012

• Two elderly patients had unilateral ophthalmoparesis and retrobulbar pain. Both had subtle lid signs of aberrant regeneration of the third nerve without preceding acute oculomotor paralysis, and both were found to have intracranial aneurysms. Although primary aberrant oculomotor regeneration has been reported previously in patients with aneurysms and meningiomas, the diagnostic importance of this sign in the elderly has not been emphasized. The presence of lid elevation on downgaze associated with slowly progressive ophthalmoplegia in patients aged 65 or older suggests aneurysm in or near the cavernous sinus.