Microvascular cranial nerve palsy

Microvascular cranial nerve palsy (MCNP) is one of the most common causes of acute double vision in the older population. 

It occurs more often in patients with diabetes and high blood pressure. MCNP is sometimes referred to as a “diabetic” palsy. This condition almost always resolves on its own without leaving any double vision.

Six muscles move your eyes. Four of these muscles attach to the front part of your eye (just behind the iris, or the colored portion of the eye). Two muscles that attach to the back of your eye are responsible for some of the up-and-down (vertical) movement and most of the twisting movement of each eye. These six muscles receive their signals from three cranial nerves that begin in the brain stem.

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