An imaging guide to the evaluation of third cranial nerve palsies

PURPOSE. To devise a cost-effective imaging guide for the evaluation of third nerve palsies (TNP), based on an extensive review of the literature. METHODS. A review of the pertinent English language literature was performed to devise a guideline for the evaluation and neuroimaging of TNP. The authors also report a retrospective review of the cost of imaging studies performed on 91 patients with TNP. RESULTS. On the basis of the available literature, an imaging guide was developed and applied to a retrospective chart review of 91 patients from a single tertiary care center (Baylor College of Medicine). The cost effectiveness as well as the efficacy of the imaging guide was analyzed. CONCLUSIONS. The evaluation of TNP can be difficult; however, using such guides may allow for more appropriate and cost-effective evaluation of these patients.