Answers to Epilogue

1. This is left oculomotor nerve palsy. The oculomotor nerve innervates the levator palpebrae superioris, ciliary/iris sphincter muscles and all extra-ocular muscles except the lateral rectus (cranial nerve VI innervation) and superior oblique (cranial nerve IV innervation). Therefore, paralysis prevents elevation of the eyelid (ptosis), pupillary dilatation and results in deficient eye adduction, supraduction and infraduction. The unopposed lateral rectus and superior oblique muscle action cause the affected eye to look downward and outward at rest. 2. Oculomotor nerve palsy is rare in children and is most commonly congenital or developmental in origin. Damage to the Edinger-Westphal/motor nuclei supplying the nerve …