Levator-sparing oculomotor nerve palsy caused by a solitary midbrain metastasis
J. R. Keane, B. Zaias and H. H. Itabashi
One month before death, a 63-year-old man with known lung carcinoma
manifested a left third-nerve palsy and crossed ataxia. The oculomotor
involvement began with a dilated left pupil and progressed to a complete
left oculomotor nerve palsy, with the exception of nearly normal lid
function. Pathologic examination revealed a solitary midbrain metastasis
involving the left third-nerve nucleus and rootlets, with the exception of
the caudal central oculomotor subnucleus and its outflow fibers.