Giant Cell Arteritis: A Rare Cause of Oculomotor Nerve Palsy

Giant cell arteriitis (GCA) is a systemic granulomatous vasculitis that affects predominantly the large arterial vessels (the aorta and its major branches) but the inflammatory process can involve arteries of any size. It usually develops in females above 50 years of age and affects the temporal arteries. The disease has unpredictable clinical course, causing six major groups of symptoms: vascular (including headache and peripheral ischemia), visual (including loss of vision and ischemic optic neuropathy), rheumatic (myalgia and muscle stiffness), neurological (transient ischemia, stroke, mononeuropathy/multiple mononeuritis), extracranial (peripheral ischemia, Raynaud phenomenon, arterial aneurisms), and constitutional (fever, weight loss, night sweats, weight loss, etc.). Rarely, GCA may lead to III cranial nerve palsy. We describe a 76-years-old male patient who developed oculomotor nerve palsy as a first manifestation of GCA.

Keywords: Giant cell arteriitis, III cranial nerve palsy, Diagnosis, Treatment.