Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA.
A 50-year-old woman presented with an acute painful complete third nerve palsy involving the pupil. Noninvasive imaging ruled out an aneurysmal compression of the third nerve, and brain magnetic resonance imaging demonstrated an intrinsic lesion of the third nerve. Work-up remained negative. All symptoms and signs resolved with steroids. In this case review, we briefly discuss the management of isolated third nerve palsies.