{'fraction_non_alphanumeric': 0.039171544349392164, 'fraction_numerical': 0.01170643854119766, 'mean_word_length': 5.121212121212121, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Isolated Oculomotor Nerve Palsy in Takayasu Arteritis-A Rare Complication.

A 39-year-old man presented to us with complaints of suddenonset, painless, right-side drooping of eyelid without loss of vision of 5 days in duration. He was a diagnosed case of Takayasu arteritis (TA) type V (left subclavian, left renal, and aorta) in 2017 and was on prednisolone 5 mg/d and oral methotrexate 10 mg every week. At the time of presentation, he had no history of fever, headache, vomiting, jaw claudication, giddiness, limb claudication, carotidynia, or abdominal pain. There was no temporal tenderness, skin rash, muscle weakness, or any other signs of vasculitis or other connective tissue diseases. He was hypertensive on metoprolol 50 mg/d. He did not have a history of tuberculosis or diabetes mellitus. On examination, there was complete right ptosis, fixed dilated pupil, and restriction in adduction, upward, and downward movement suggestive of third cranial nerve palsy (Figure A). His visual acuity was normal in both eyes. Other cranial nerves examination including fundoscopy examination was normal. Other central nervous system examination was unremarkable. There was no proptosis or ocular tenderness. There was absent left brachial and radial artery pulse; all other peripheral pulses were felt. There was no bruit. There were no other systemic examination findings. Investigations revealed raised C-reactive protein (CRP; 23.78 mg/L) and erythrocyte sedimentation rate (52 mm in the first hour). Magnetic resonance imaging of the brain with magnetic resonance angiography revealed T2 central hyperintensity involving bilateral optic nerve, with the right side more than the left one. Antineutrophil cytoplasmic antibodies and antinuclear antibody (indirect immunofluorescence), hepatitis B, hepatitis C, and HIV were negative. In view of sudden-onset third cranial nerve palsy along with raised inflammatory markers (erythrocyte sedimentation rate, CRP), active vasculitis was suspected and initiated on 1 mg/kg prednisolone (60 mg/d) with mycophenolate (2 g/d) as steroid-sparing agent. On follow-up after 2 weeks, the ptosis and eyeball movements recovered completely (Figure B), and CRP decreased to 4.6 mg/L.