[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
January 1981

Paralysis of Cranial Nerves III, IV, and VI: Cause and Prognosis in 1,000 Cases

Author Affiliations

From the Department of Ophthalmology, Mayo Clinic and Mayo Foundation, Rochester, Minn. Dr Rush is now with the Department of Ophthalmology, University of South Florida Medical Center, Tampa.

Arch Ophthalmol. 1981;99(1):76-79. doi:10.1001/archopht.1981.03930010078006

• An unselected series of 1,000 cases of paralysis of cranial nerves III, IV, and VI was retrospectively analyzed regarding ultimate recovery and final causal diagnosis. The frequency of involvement of the third, fourth, and sixth cranial nerves was relatively unchanged from earlier similar reports. The number of patients (263) whose cranial nerve paralysis was initially of undetermined cause was surprisingly high despite the availability of computerized tomographic scanning. Subsequently, the cause for the paralysis was diagnosed in only ten of the 127 patients who could be traced. About half (51%) of the patients with no known cause for paralysis underwent spontaneous remission. Forty-eight percent of all patients recovered. Cranial nerve impairment due to vascular disease (diabetes mellitus, atherosclerosis, or hypertension) was temporary in 71% of the patients, regardless of the cranial nerve affected. Patients with palsies caused by aneurysm, trauma, and neoplasm were predictably less likely to recover.