Spectrum of non-ischemic oculomotor nerve palsies at a tertiary care centre − case series and literature review

The unique neuroanatomy of the oculomotor nerve contributes to its varied and complex presentation. The nerve is particularly susceptible in its basilar and cavernous sinus segments. Although neuroimaging may be initially deferred in a pupil-sparing ONP in patients with vasculopathic risk factors, the "rule of pupil" may not always be followed. The 19 cases that we described are discussed in detail, along with a review of the literature. This wide spectrum of presentations helps to understand and correlate the nerve's anatomical course and highlights the importance of a detailed neurological evaluation to facilitate targeted imaging of the suspected region of pathology.