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Within 3\u2009weeks he developed complete left-sided ptosis with loss of ocular adduction, elevation and depression. There were no other neurological features; CT and MRI scans of the brain were normal. He had no history of diabetes and blood pressure was reasonably controlled. A diagnosis of capecitabine-induced cranial nerve III palsy was made and no further capecitabine was given. The patient\u2019s ptosis improved within a month and there was full resolution within 2\u2009months. He continued with follow-up surveillance CT scans for cholangiocarcinoma. This is the first reported cranial nerve III palsy due to capecitabine, the aetiology of which is uncertain. It is important that clinicians are able to recognise this as a potential complication as capecitabine is commonly given in combination with other agents for various cancer types.<\/jats:p>","DOI":"10.1136\/bcr-2024-263242","type":"journal-article","created":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T03:55:37Z","timestamp":1734753337000},"page":"e263242","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Cranial nerve III palsy induced by adjuvant capecitabine for cholangiocarcinoma"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0762-1726","authenticated-orcid":false,"given":"Maurice","family":"Dungey","sequence":"first","affiliation":[{"name":"Department of Genetics, Genomics and Cancer Sciences, University of Leicester, Leicester, UK"},{"name":"Medical Oncology, University Hospitals of Leicester NHS Trust, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norene","family":"Ashmore","sequence":"additional","affiliation":[{"name":"Orthoptics, University Hospitals of Leicester NHS Trust, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean","family":"Dulloo","sequence":"additional","affiliation":[{"name":"Medical Oncology, University Hospitals of Leicester NHS Trust, Leicester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,20]]},"reference":[{"key":"2025082801035040000_17.12.e263242.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30915-X"},{"key":"2025082801035040000_17.12.e263242.2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.02178"},{"key":"2025082801035040000_17.12.e263242.3","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.annonc.2022.10.506","article-title":"Biliary tract cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"34","author":"Vogel","year":"2023","journal-title":"Ann Oncol"},{"key":"2025082801035040000_17.12.e263242.4","doi-asserted-by":"crossref","first-page":"1983","DOI":"10.3892\/ol.2014.2454","article-title":"Isolated oculomotor nerve palsy as a paraneoplastic manifestation of gastric diffuse large B-cell lymphoma: A case report","volume":"8","author":"Yan","year":"2014","journal-title":"Oncol Lett"},{"key":"2025082801035040000_17.12.e263242.5","unstructured":"Capecitabine . 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