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Aberrant regeneration of the third nerve (oculomotor synkinesis)
  1. Daniel Ross Gold1,
  2. Robert K Shin1,2,
  3. Nirali P Bhatt2,
  4. Eric R Eggenberger3
  1. 1Department of Neurology, University of Maryland, Baltimore, Maryland, USA
  2. 2Department of Ophthalmology and Visual Sciences, University of Maryland, Baltimore, Maryland, USA
  3. 3Departments of Neurology and Ophthalmology, Michigan State University, East Lansing, Michigan, USA
  1. Correspondence to Dr Daniel Ross Gold, Department of Neurology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104; Daniel.Gold{at}


Aberrant regeneration of a third nerve palsy (oculomotor synkinesis) excludes an ischaemic cause and in the absence of relevant trauma strongly suggests a compressive aetiology. A scan is mandatory in such cases. We describe the case of a 52-year-old woman who presented with complete pupil-involving third nerve palsy from a posterior communicating artery aneurysm, who later developed widespread aberrant regeneration of pupil, eyelid and third nerve territory rectus muscles.

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