[Third nerve palsy as the only manifestation of occult temporal arteritis].

CASE REPORT: Two patients (80 and 67 year-old) presented with diplopia for a sudden right 3rd cranial nerve palsy without other ocular or systemic symptoms related to temporal arteritis. Erythrocyte sedimentation rate and C-reactive protein levels were normal. Subsequent biopsy of the superficial temporal artery confirmed the diagnosis of temporal arteritis.

DISCUSSION: Patients with ocular nerve palsy could have occult temporal arteritis. Aged patients with an acute ocular ischemic lesion, without elevated erythrocyte sedimentation rate, C-reactive protein levels and systemic symptoms, should raise a high index of suspicion for temporal arteritis.