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Answers to Epilogue
  1. Helen Elizabeth Groves1,
  2. Sharon Christie2,
  3. Gerry McGinnity3,
  4. Donncha Hanrahan4,
  5. Andrew Thompson5
  1. 1Department of Paediatrics, Royal Belfast Hospital For Sick Children, Belfast, UK
  2. 2Paediatric Infectious Disease Department, Royal Belfast Hospital for Sick Children, Belfast, UK
  3. 3Department of Ophthalmology, Royal Victoria Hospital, Belfast, UK
  4. 4Department of Paediatric Neurology, Royal Belfast Hospital for Sick Children, Belfast, UK
  5. 5Department of General Paediatrics, Royal Belfast Hospital for Sick Children, Belfast, UK
  1. Correspondence to Dr Helen Elizabeth Groves, Department of Paediatrics, Royal Belfast Hospital For Sick Children, Belfast BT12 6BA, UK; hgroves01{at}qub.ac.uk

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Answers to the questions on page 294

  1. This is left oculomotor nerve palsy.

The oculomotor nerve innervates the levator palpebrae superioris, ciliary/iris sphincter muscles and all extra-ocular muscles except the lateral rectus (cranial nerve VI innervation) and superior oblique (cranial nerve IV innervation). Therefore, paralysis prevents elevation of the eyelid (ptosis), pupillary dilatation and results in deficient eye adduction, supraduction and infraduction. The unopposed lateral rectus and superior oblique muscle action cause the affected eye to look downward and outward at rest.

2. Oculomotor nerve palsy is rare in children and is most commonly congenital or developmental in origin. Damage to the Edinger-Westphal/motor nuclei supplying the nerve …

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