Evaluation of third nerve palsy remains problematic

September 1, 2002
Andrew G. Lee, MD

He is editor of The Neuro-Connection. He is professor of ophthalmology, neurology, and neurosurgery, The H. Stanley Thompson Neuro-ophthalmology Clinic, Department of Ophthalmology at the University of Iowa Hospitals and Clinics, Iowa City.

It's 4:55 p.m. on a Friday, last patient of the day-a 50-year-old man with diabetes and hypertension with new-onset right-sided ptosis and diplopia. Examination reveals a right third nerve palsy (TNP). What is the next most appropriate step?