Superior branch palsy of the oculomotor nerve caused by acute sphenoid sinusitis.

A 52-year-old man presented with unilateral headache for 6 days. Physical examination revealed an ipsilateral paresis of the superior division of the oculomotor nerve with chemosis. CT scan of the paranasal sinuses showed ipsilateral sphenoid sinusitis with cavernous sinus involvement. The symptoms were completely improved by medical treatment only.