2、颅内占位性病变（intracranialspaceoccupyinglesion）:在颅脑损伤颅内压增细菌及脑肿瘤晚期，一般皆表示已发生小脑幕切迹疝。表现为病侧瞳孔扩大及光反应消失，对侧肢体可出现瘫痪，继之对侧瞳孔也出现扩大，同时伴有意识障碍。根据病史及头颅CT检查多能明确诊断。3、海绵窦血栓形成及窦内动脉瘤:可表现为海绵窦综合征，除了动眼神经瘫痪外，还有三叉神经*支损害，眶内软组织，上下眼睑、球结膜、额部头皮及鼻根部充血水肿，眼球突出或视乳头水肿，炎症所致者常伴有全身感染症状，结合眶部X线片及腰椎穿刺及血常规检查可明确诊断。4、眶上裂综合征与眶尖综合征:前者具有动眼、滑车、外展神经与三叉神经*支功能障碍，后者除此3对颅神经损害外，常伴有视力障碍，结合眶部视神经孔X线片，血液化验、眶部CT等多能明确诊断。5、脑膜炎:脑膜炎引起的动眼神经损害多为双侧性，且多与滑车、外展神经同时受累。脑脊液检查细胞数、蛋白定量增细菌。关键诊断细菌素上睑下垂和斜视 (常见)：根据动眼神经支配的眼外肌麻痹表现，患眼呈不同程度的上睑下垂和外斜视，图7 右侧先天性动眼神经麻痹，受累眼外斜视、正常的瞳孔集合反应、轻微的上睑下垂、上抬受限、内陷和内收伴有轻度下斜和内旋斜视。眼球向上、向下和向内运动均受限。眼球轻度突出。眼球向下转时有内旋转。瞳孔改变 (常见)：瞳孔散大，对光反射和近反射消失，调节麻痹弱视 (常见)：由于视觉刺激减少，视力下降且不能矫正，先天性常见假性Graefe 征 (不常见)：患眼试图向下转时，上睑上举假性Argyll-Robertson 瞳孔 (不常见)：患眼瞳孔散大，对光反应消失。当眼球集合和向内转时，瞳孔收缩。水平注视眼睑运动障碍 (不常见)：外转时睑裂变小，内转时睑裂变宽动眼神经错向综合征 (不常见)：垂直方向注视时眼球后退、垂直方向注视时眼球内转。
2, intracranial space occupying lesions (intracranialspaceoccupyinglesion): intracranial pressure increased intracranial pressure in the brain and endometrial tumors, generally all have said that the tentorial herniation has occurred. The performance of the patient's pupil dilation and photoreaction disappeared, the contralateral limb paralysis can occur, followed by contralateral pupil also appear to expand, accompanied by disturbance of consciousness. According to medical history and head CT can be more clear diagnosis. 3, cavernous sinus thrombosis and sinus aneurysm: can be expressed as cavernous sinus syndrome, in addition to oculomotor nerve paralysis, there are the first trigeminal nerve damage, orbital soft tissue, upper and lower eyelids, conjunctival, frontal scalp and Nasal congestion and edema, prominent or papilledema, inflammation often accompanied by symptoms of systemic infection, combined with orbital X-ray and lumbar puncture and blood tests can confirm the diagnosis. 4, supraorbital fissure syndrome and orbital apex syndrome: the former has a moving eye, pulley, abducens nerve and the first trigeminal dysfunction, the latter in addition to three cranial nerve damage, often accompanied by visual impairment, combined with Orbital optic nerve hole X-ray, blood tests, orbital CT and other more able to confirm the diagnosis. 5, meningitis: meningitis caused by oculomotor damage are mostly bilateral, and more with the tackle, abducens nerve involvement. Check the number of cerebrospinal fluid cells, protein quantitative bacteria. Key diagnoses Bacterial ptosis and strabismus (common): According to the oculomotor innervation of the extraocular muscle paralysis, the affected eyes were varying degrees of ptosis and exotropia, Figure 7 right side of the congenital oculomotor nerve paralysis, involvement Extrathoracic, normal pupil set reaction, slight ptosis, limited elevation, retraction and adduction accompanied by mild hypopynthus and pronation. Eye up, down and inward movement are limited. Eyeballs are slightly prominent. Eye turn down when there is rotation. Pupil changes (common): dilated pupils, loss of light reflex and reflex, paralysis of the amblyopia (common): reduced visual acuity due to decreased vision and can not be corrected, congenital common false Graefe sign (uncommon): affected eyes Pseudo Argyll-Robertson pupil (uncommon) on the upper eyelid when trying to turn down: the affected pupil becomes dizzy and reaction to light disappears. The pupil contracts as the eyeballs gather and turn inward. Horizontal fixation of eyelid dyskinesia (uncommon): external transitional fissure is small, internal transitional fissure widened oculomotor syndrome (not common): the vertical direction of the retroreflective gaze, the vertical direction of the eye when the turn.

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