The oculomotor nerve belongs to the group of mixed nerves. It consists of motor and parasympathetic fibers. It is due to the oculomotor nerve that the raising, lowering, rotation and other movements of the eyeball are carried out. But his role is much more important and is not only that. This nerve, which is a necessary functional component for the normal functioning of the visual analyzer, also ensures the normal movements of the eyelid and the reaction of the pupil to light.
Oculomotor nerve damage: symptoms, main manifestations
It is worth noting that an isolated violation of this nerve is very rare. Here are the main symptoms:
- immobility of the muscle of the upper eyelid and, as a result, its partial or complete omission;
- lack of resistance to the superior oblique and inferior rectus muscles, resulting in a diagnosis of exotropia;
- immobility of the internal rectus muscle and, as a result, the occurrence of the phenomenon of doubling (diplopia);
- lack of pupil reaction to light;
- violationinnervation of the internal muscle and, as a result, the inability of the eye to adapt to objects located at different distances from it;
- absence of contraction of the rectus muscles of both eyes, which makes it impossible to turn the eyeballs inward;
- protrusion of the eyes due to loss of tone of the external muscles, this confirms that there was a lesion of the oculomotor nerve.
Most often, all of the above symptoms are combined with concomitant manifestations that cause dysfunction of friendly nerve fibers, nearby muscle groups and organs.
Diagnosis features
If all fibers of the oculomotor nerve are affected, then the manifestation of this is so obvious that the definition of the diagnosis does not raise any doubts. First of all, this is ptosis (drooping of the upper eyelid), pupil dilation, deviation of the eyeball outward and downward.
However, various combinations of ptosis and pupil dilation, as well as any other disorders caused by muscle paresis, are very common. In such cases, we can talk about both the primary stage of damage to the fibers of the oculomotor nerve, and other possible disorders of related organs. It is much more difficult to make a timely and accurate diagnosis in such cases.
Causes of damage, the role of timely diagnosis and treatment
The main causes of damage to the oculomotor nerve are:
- injuries;
- neuroinfectious diseases;
- brain tumorsvarious etiologies;
- pneurysm of cerebral vessels;
- diabetes mellitus;
- stroke.
However, most often the causes of partial or complete damage to the nuclei or fibers of the oculomotor nerve remain only an assumption. It is impossible to establish them exactly. The human body is a very complex system, and not fully understood, but it is absolutely known that the disruption of one of its components along the chain transmits it to other organs, nerves and muscles.
For example, neuropathy of the oculomotor nerve in an isolated form is very rare and is most often a concomitant manifestation of chronic or congenital diseases, as well as the result of traumatic brain injuries and tumors. With proper and timely treatment, this disease can pass without complications and consequences.
If neuropathy of the oculomotor nerve is suspected, it is imperative to take a whole course of tests, including blood for the presence of a neuroinfection in the body. Only after receiving the results and confirming the diagnosis, it is possible to prescribe a course of treatment and be sure to conduct repeated tests.
Diagnosis of disease
If there is a suspicion of a violation of the function of the oculomotor nerve, it is possible to confirm or refute this, as well as to identify the real cause of the deviation, only by conducting high-quality professional diagnostics. Most often this is done by an ophthalmologist, and only in some cases, if the diagnosis is in doubt,an additional appointment with a neurologist.
Diagnosis and examination of the organs of vision is carried out on modern computer equipment, as well as through a variety of specialized tests. As a result, after a comprehensive examination, the patient can be diagnosed.
Also, in addition to standard procedures for checking the condition of the fundus, determining the quality of vision, eye mobility, detecting pupil reactions to light, MRI and angiography are performed. If the etiology is not fully identified, and even if the damage to the oculomotor nerve is confirmed, constant monitoring of the patient is mandatory, as well as re-examinations.
Constant monitoring of the condition of the affected organ is a prerequisite for treatment
This is very important, because timely detection of further progression of the disease, as well as constant monitoring of the treatment prescribed by the doctor, are of great importance for the entire condition of the eye and all further human activity. So, for example, neuritis of the oculomotor nerve in most cases has a positive trend if the patient complies with all prescriptions, however, treatment is carried out only with the constant supervision of specialists.
Science does not stand still, and recently one of the innovative diagnostic methods is superposition electromagnetic scanning of the oculomotor muscles to assess their functional activity. This method significantly reducesthe time allotted to identify the cause of the violation, and it becomes possible to begin treatment much faster and achieve positive results.
The most effective treatments
As soon as there is a suspicion of a possible violation of the functions of the oculomotor nerve, the patient is immediately recommended to do exercises to strengthen the muscle responsible for the movement of the organs of vision. Of course, trying to strengthen it as much as possible is not bad at all, and not only when problems appear, but even for prevention, but this is only suitable at the very beginning of the violation. If a fairly large part is already affected, these exercises will not help to heal, although they are still an integral part of the treatment.
The next most common recommendation is to take appropriate vitamins and medications, which also work to strengthen the eye muscle and restore its function. These can be special vitamins, eye drops, glasses, dressings that make the sore eye work more actively.
Special computer programs are very popular today. Basically, these are the so-called stereo images.
The use of computer programs in the treatment of eye muscle dysfunctions
It has been proven that when viewing such pictures, the eye muscles are trained, and, accordingly, blood circulation in them improves. At this time, the nerves responsible for the normal functioning of the eye are in highin a tense state, and all the reserves of the body are aimed at controlling them, because most of the other organs at the time of viewing are in a relaxed state and do not require such attention.
Stereo pictures really have a very positive result on vision, but they can be used only after consulting a doctor. After all, in some cases they are just a panacea, and in others they can cause irreparable harm.
Modern treatments
If, after several complementary tests, it is confirmed that the oculomotor nerve is affected, treatment should begin without delay. One of the positively proven and used in practical ophthalmology for several years now is the treatment with electrophoresis of the affected areas with 1.5% Neuromidin.
It is carried out by applying three round electrodes of different area to each other, two smaller of which are placed on the skin of the orbital region and upper eyelids with eyes closed. They are connected with a forked wire to an electrode of a larger area, which is placed in the cervical-occipital region of the patient's head.
The duration of this procedure with a course of treatment up to 15 sessions carried out daily is 15-20 minutes. The method allows to locally and purposefully influence the defective neuromuscular synapses of the eyeball, as well as the nuclear structures of the oculomotor nerves.
When surgeryrequired
In the vast majority of cases, surgical intervention is performed. It aims to eliminate the cause of the disease. In most cases, thanks to the capabilities of modern medicine, operations are performed under local anesthesia, and it turns out to do without hospitalization of the patient.
Any dysfunction of the eye muscle and varying degrees of damage to the oculomotor nerve lead to rather serious consequences. If one eye begins to see poorly, the second one tries as much as possible to compensate for this violation. In the event that ptosis begins to develop, nearby muscles for some time perform lifting of the eyelid on their own. That is why, from the very birth of a child, it is recommended to undergo regular examinations by an ophthalmologist and in no case should you skip them. This is very important, because only prevention and timely diagnosis guarantees the most optimal outcome of treatment.
