Abstract
Congenital third nerve palsy is an uncommon condition that may result from perinatal trauma to the peripheral oculomotor nerve or from brainstem injury in utero. 1 Several reports have documented oculomotor synkinesis in this condition, which may produce elevation of the ptotic eyelid on attempted depression or adduction of the affected eye. 1 We describe a patient with an unusual congenital third nerve palsy who had episodic upper-eyelid elevation caused by a platysma-levator synkinesis. Report of a Case. —A 4-year-old girl was referred for evaluation of a right congenital third nerve palsy. Although there was no history of birth trauma or forceps delivery, she had a birthmark on the right side of her forehead until age 1 year. A previous neurologic examination disclosed no other abnormalities. Results of a high-resolution magnetic resonance scan of the head and orbits with gadolinium enhancement were normal. Corrected visual acuity was 20/100 OD and
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