SYNOPSIS A patient with a previously diagnosed left Horner's syndrome suddenly developed severe pain in the left eye and diplopia. Ipsilateral third cranial nerve palsy was present, but the pupil remained small and minimally reactive. A carotid angiogram showed a large aneurysm of the left internal carotid‐posterior communicating junction. Pain was only relieved after successful clipping of the aneurysm and liberation of the third nerve. The effects of combined sympathetic and parasympathetic denervation of the pupil and the mechanism of their development in regard to the differential diagnosis of painful ophthalmoplegia are discussed.
No takes yet. Share an insight, caveat, or question.
Román‐Campos et al. (1979) studied this question.