Multiple cranial nerve dysfunction can occur with primary intracranial processes (neoplasm, basilarvertebral insufficiency, congenital defects, aneurysms, dural vein thrombosis, multiple sclerosis), myopathy or neuromuscular junction disorder (myasthenia gravis, botulism, orbital 'myositis', ocular myopathy), and as a manifestation of a more systemic disorder (sarcoidosis, endocrinopathy, conne...