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KMID : 0361020090520090784
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Korean Journal of Otolaryngology - Head and Neck Surgery
2009 Volume.52 No. 9 p.784 ~ p.788
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The 3rd Cranial Nerve Palsy due to Posterior Communicating Artery Aneurism Mimicking Acute Vestibulopathy (Vestbular Neuritis)
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Yun Kyung-Sub
Lee Chang-Min
Jung Jae-Yun
Suh Myung-Whan
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Abstract
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We present a 66-year old woman complaining of dizziness and vomiting for the previous three days. Her symptoms were quite similar to vestibular neuritis except for mild headache. Spon- taneous nystagmus recording, head shake test, and slow harmonic acceleration results were also similar to vestibular neuritis. But the caloric test was not consistent with the chair test results. During the neurologic examination, ptosis, mydriasis, and the diplopia in the left eye were de- tected, which was indicative of central organic pathology. Bilateral posterior communicating ar- tery aneurysm that was compressing the left oculomotor nerve was detected by CT angiography. A careful and precise neurologic examination should never be neglected when examining a diz- zy patient. It was also noticeable that, acute third nerve palsy may present as intermittent sac- cades which mimic spontaneous nystagmus in vestibular neuritis.
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KEYWORD
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Oculomotor nerve, Aneurysm·Posterior communicating artery aneurysm
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