Abstract • A patient with a traumatic right third nerve paresis had a contralateral oculomotor synkinesis develop that involved the left upper eyelid. With infraduction in adduction of the nonparetic left globe, the left upper eyelid was elevated. Elevation of the right upper eyelid was present in adduction of the paretic eye but absent in downgaze. To our knowledge this is the first description of the pseudo-Graefe phenomenon developing contralateral to the regenerating paretic third nerve. References 1. Bielschowsky A. Lectures on motor anomalies in the eyes, II: paralysis of individual eye muscles . Arch Ophthalmol . 1935;13:33-59.Crossref 2. Cox TA, Wurster JB, Godfrey WA. Primary aberrant oculomotor regeneration due to intracranial aneurysm . Arch Neurol . 1979;36:570-571.Crossref 3. Czarnecki JSC, Thompson HS. The iris sphincter in aberrant regeneration of the third nerve . Arch Ophthalmol . 1978;96:1606-1610.Crossref 4. Ford FR, Walsh FB, King AB. Clinical observations on the pupillary phenomena resulting from regeneration of the third nerve with special reference to the Argyll Robertson pupil . Bull Johns Hopkins Hosp . 1941;68:309-318. 5. Forster RK, Schatz NJ, Smith JL. A subtle eyelid sign in aberrant regeneration of the third nerve . Am J Ophthalmol . 1969;67:696-698. 6. Gowers WR. The movements of the eyelids . Med Clin Trans . 1879;62:429-440. 7. Iwabuchi T, Suzuki M, Nakaoka T, Suzuki S. Oculomotor nerve anastomosis . Neurosurgery . 1982;10:490-491.Crossref 8. Keane JR. Bilateral aberrant regeneration of the third cranial nerve following trauma: case report . J Neurosurg . 1975;43:95-97.Crossref 9. Kerns JM, Smith DR, Jannotta FS, Alper MG. Oculomotor nerve regeneration after aneurysm surgery . Am J Ophthalmol . 1979;87:225-233. 10. Levin PM. Intracranial aneurysms: clinicopathologic considerations of oculomotor-nerve regeneration and intracerebral hemorrhage . Arch Neurol Psychiatry . 1952;67:771-786.Crossref 11. Spector RH, Faria MA. Aberrant regeneration of the inferior division of the oculomotor nerve . Arch Neurol . 1981;38:460-461.Crossref 12. Sturm RJ, Smith JL. Aberrant regeneration of the oculomotor nerve: monocular optokinetic response . Ophthalmology . 1965;69:1054-1060. 13. Walsh FB, Hoyt WF. Clinical Neuro Ophthalmology . Baltimore, Md: Williams & Wilkins; 1969:256-261. 14. Wartenberg R. Associated movements in the oculomotor and facial muscles . Arch Neurol Psychiatry . 1946;55:439-488.Crossref 15. Bender MB, Fulton JF. Factors in functional recovery following section of the oculomotor nerve in monkeys . J Neurol Neurosurg Psychiatry . 1939;2:285-292.Crossref 16. Bender MB, Fulton JF. Functional recovery in ocular muscles of a chimpanzee after section of oculomotor nerve . J Neurophysiol . 1938;1:144-151. 17. Lyle DG. Experimental oculomotor nerve regeneration . Am J Ophthalmol . 1966;61:1239-1243. 18. Schatz NJ, Savino PJ, Corbett JJ. Primary aberrant oculomotor regeneration: a sign of cavernous meningioma . Arch Neurol . 1977;34:29-32.Crossref 19. Lepore F, Glaser JS. Misdirection revisited: a critical appraisal of acquired oculomotor synkinesis . Arch Ophthalmol . 1980;98:2206-2209.Crossref 20. Sibony PA, Lessell S. Transient oculomotor synkinesis in temporal arteritis . Arch Neurol . 1984;44:87-88.Crossref 21. Gardner WJ. Cross-talk: the paradoxical transmission of a nerve impulse . Arch Neurol . 1966;14:149-156.Crossref 22. Sulora T. Aberrant conduction in the human peripheral nerve: ephaptic transmission . Neurology . 1982;32:712-719.Crossref 23. McGovern ST, Crompton JL, Engham PN. Trigemino-abducens synkinesis: an unusual case of aberrant regeneration . Aust NZ J Ophthalmol . 1986;14:275-279.Crossref 24. Tomasulo RA. Aberrant conduction in human peripheral nerve: ephaptic transmission? Neurology . 1982;32:712-719.Crossref 25. Sibony PA, Evinger C, Lessell S. Retrograde horseradish peroxidase transport after oculomotor nerve injury . Invest Ophthalmol Vis Sci . 1986;27:975-980. 26. Fernandez E, Pallini R, Gangitano C, et al. Oculomotor nerve regeneration in rats . J Neurosurg . 1987;67:428-437.Crossref 27. Aguayo AJ. Axonal regeneration from injured neurons in the adult mammalian central nervous system . In: Cotman CW, ed. Synaptic Plasticity . New York, NY: Guilford Press; 1985:457-484.
Archives of Neurology – American Medical Association
Published: Sep 1, 1989
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