Bilateral intra-axial ocularmotor palsy. Two cases

Bilateral palsy of the common ocular motornerve (III) was observed in two patients with an intra-axial lesion due to hemorrhage in one and ischemia in the other. The lesions involved the cerebral peduncle in the periaqueductal region and the nuclear complex of the III in the first case. Bilateral infarct of the thalamus was seen in the second. Clinical manifestations were transitory except for the oculormotor impairment. In the first patient, oculomotricity was dissociated as intrinsic motricity was spared. These exceptional cases demonstrate a syndrome with unique oculomotor expression resulting from intra-axial oculomotor lesions. Prognosis varies and is related to the ischemia or hemorrhagic nature of the causal lesion and its localization.