Episodic Oculomotor Nerve Palsy with Intracranial Hypertension and Carcinomatous Meningitis

Sahin, Turgut; Aksun, Zerin Ozaydın; Işıkay, Canan Togay; Şener, Özden

doi:10.1080/01658107.2020.1746815

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…This case is unusual as it presents a patient with cranial nerve III palsy symptoms as the initial sole physical manifestation of underlying leptomeningeal disease from NHL, which is rare with a few documented cases of episodic oculomotor nerve palsy, and usually from breast malignancy [ 11 - 12 ]. The occurrence of oculomotor nerve palsy can be considered a potential differential for an underlying cause, as in this case with imaging that did not show contrast-enhancing lesions or associated surrounding edema [ 13 - 14 ].…”

Section: Discussionmentioning

confidence: 99%

Cranial Nerve III Palsy as the First Sign of Carcinomatous Meningitis From Non-Hodgkin’s Lymphoma

Velez Oquendo,

Alcantar,

Gupta

2024

Cureus

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Carcinomatous meningitis (CM) is characterized by the multifocal dissemination of malignant cells into the cerebrospinal fluid (CSF), pia mater, and subarachnoid space. Involvement can occur in the advanced stage of malignancy, causing multifocal involvement and a wide array of symptoms. Diagnosis requires suspicions and a multimodal approach that includes imaging, lumbar puncture, and diagnostic laboratory evaluation. This case represents a female with a history of non-Hodgkin's lymphoma (NHL) and venous thromboembolism on chronic anticoagulation who presented due to acute encephalopathy, hallucinations, and right cranial nerve III palsy for 10 days before arrival. Computed tomography (CT) and angiography of the brain did not show any intracranial abnormalities. Subsequent magnetic resonance imaging (MRI) was without signs of infarction, hemorrhage, or abnormal enhancement, with the MRI of the orbits showing asymmetric linear enhancement anterior to the superior pons and midbrain on the right. Initial differential included a paraneoplastic syndrome, but there was no obvious evidence of pathological enhancement on MRI. Due to progressive bulbar symptoms, a lumbar puncture was performed with cerebrospinal fluid diagnostic workup with cytology showing monoclonal B-cell proliferation consistent with lymphoma. This case illustrates a rare but specific finding of CM as cranial nerve III palsy symptoms in this patient who did not have imaging findings that would reflect her symptoms on the initial MRI of the brain. Furthermore, diagnosing CM is complex and involves a combination of multiple diagnostic and treatment modalities. It is important to recognize the condition early to improve the patient's quality of life, prolong survival, and stabilize neurological deterioration.

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Section: Discussionmentioning

confidence: 99%

Cranial Nerve III Palsy as the First Sign of Carcinomatous Meningitis From Non-Hodgkin’s Lymphoma

Velez Oquendo,

Alcantar,

Gupta

2024

Cureus

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“…This occurs when the brainstem moves downward, stretching the VI pair as it crosses over the petrous ridge and enters Dorello’s canal. [ 10 , 11 ] The involvement of the third nerve could be explained by its compression anywhere along its course from the fascicle to the orbit. [ 1 ] On the other hand, paralysis of the VII nerve could be justified by the traction on the nerve caused by IH before entering the temporal bone.…”

Section: Discussionmentioning

confidence: 99%

Cavum septum pellucidum and vergae cyst: A symptomatic case with intracranial hypertension and multiple nerve involvement

Ferreira

Medeiros

Cwajg

et al. 2022

Surgical Neurology International

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Background: Cavum septum pellucidum (CSP) and cavum vergae (CV) are normal anatomical variations present in some children, adolescents, and adults. When the cavity is larger than normal, it is called a cyst. Symptomatic cases of CSP and CV cyst are rare, and the clinical presentation is varied. A case with multiple nerve involvement is described. Case Description: A healthy 17-year-old female presented a sudden headache, right cervicobrachialgia, right ptosis, visual changes, and left facial paralysis over 10 days. Head magnetic resonance imaging revealed CSP and CV cyst. Inflammation, infection, and vascular disorders were ruled out. We decided to perform a right transfrontal endoscopic intraventricular septostomy and a right Monro foraminoplasty, which were successful. One month after surgery, the patient had no more signs or symptoms. She has remained asymptomatic for the past year. Conclusion: Multiple nerve involvement was directly related to CSP and CV cyst. The cyst bilaterally occluded the foramen of Monro causing intracranial hypertension. It was possible to obtain complete resolution of the clinical features through neuroendoscopic fenestration and foraminoplasty.

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Unilateral Oculomotor Nerve Palsy Associated with Leptomeningeal Carcinomatosis and Intracranial Hypertension

Cho¹,

Park²,

Seo³

2021

J Korean Neurol Assoc

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Meningeal carcinomatosis is caused by cancer cells invading the meninges and can cause cranial nerve palsies or intracranial hypertension. Intracranial hypertension can present various symptoms such as headache, visual loss, diplopia and may rarely include unilateral cranial nerve palsy. We report a 57-year-old female with leptomeningeal carcinomatosis and intracranial hypertension who presented as unilateral oculomotor nerve palsy.

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Episodic Oculomotor Nerve Palsy with Intracranial Hypertension and Carcinomatous Meningitis

Cited by 3 publications

References 7 publications

Cranial Nerve III Palsy as the First Sign of Carcinomatous Meningitis From Non-Hodgkin’s Lymphoma

Cranial Nerve III Palsy as the First Sign of Carcinomatous Meningitis From Non-Hodgkin’s Lymphoma

Cavum septum pellucidum and vergae cyst: A symptomatic case with intracranial hypertension and multiple nerve involvement

Unilateral Oculomotor Nerve Palsy Associated with Leptomeningeal Carcinomatosis and Intracranial Hypertension

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