Acute ophthalmoplegia (ophthalmoparesis)

A. Acute one-sided ophthalmoplegia (ophthalmoparesis)

The main causes of acute ophthalmoplegia (ophthalmoparesis):

1. Aneurysm or vascular abnormality (hemorrhage or nerve compression) in the region of the connection of the posterior connective artery and the internal carotid artery (oculomotor nerve) or the anterior lower cerebellar and the main artery (the distracting nerve).
2. Small hemorrhages in the region of the brainstem (embolism, leukemia, coagulopathy).
3. Ophthalmoplegic migraine (transitory lesion of the oculomotor nerve in 85% of cases and a diverting or blockage nerve in 15%).
4. Cavernous sinus thrombosis (the source of sinus thrombosis almost always consists of infectious processes in the area of the mouth, nose or face.
5. Thrombosis of the inferior stony sinus (source is the infection of the middle ear, defective, facial nerve and ganglion of the trigeminal nerve are affected).
6. Fistula of the cavernous sinus (traumatic origin).
7. Tumor of the brain (brain stem glioma, craniopharyngioma, pituitary adenoma, nasopharyngeal carcinoma, lymphoma, pineal gland tumor).
8. Idiopathic cranial polyneuropathy (in the case of the often observed unilateral defeat).
9. Myasthenia gravis.
10. Tumor of the orbit (dermoid cyst, hemangioma, metastatic neuroblastoma, optical glioma, rhabdomyosarcoma) and inflammatory processes in the orbit (orbital pseudotumor, sarcoidosis).
11. Trauma (fracture of orbital bones with muscle damage)
12. Intracranial hypertension (pinpring of the temporal lobe in the opening of the cerebellum nodule; pseudotumor cerebri).
13. Demyelinating processes, affecting, for example, the roots of the glanding nerves (III, IV and VI nerves).
14. Tholos-Hunt syndrome.

[1], [2]

B. Acute bilateral ophthalmoplegia (ophthalmoparesis)

Most of the reasons mentioned above, which cause acute unilateral ophthalmoplegia, can also lead to acute bilateral ophthalmoplegia.

Main reasons:

1. Botulism, HIV infection (encephalopathy).
2. Basilar meningitis (including carcinomatous).
3. Intoxications (anticonvulsants, tricyclic antidepressants, other psychotropic drugs with toxic concentrations in the blood serum).
4. Stem forms of encephalitis (echoviruses, coxsacks, adenoviruses).
5. ONMK in the region of the brainstem.
6. Diphtheria.
7. Thrombosis of the cavernous sinus.
8. Carotid cavernous fistula.
9. Myasthenia gravis.
10. Thyrotoxicosis.
11. Hematoma of the midbrain.
12. Syndrome infringement of a trunk of a brain (a transtialial wedge).
13. Apoplexy of the pituitary gland.
14. Miller Fischer Syndrome.
15. Lee's disease (subacute necrotizing encephalomyelitis).
16. Multiple sclerosis.
17. Neuroleptic malignant syndrome (rarely).
18. Pseudotumor of the orbit.
19. Paraneoplastic encephalomyelitis.
20. Polyradiculopathy involving cranial nerves.
21. Craniocerebral injury.
22. Encephalopathy Wernicke.
23. Psychogenic form (pseudo-ophthalmoplegia).

[3], [4], [5], [6], [7]