Optic Tract Syndrome, Horner's Syndrome, and Trochlear Nerve Palsy due to Suprasellar Germinoma

Abstract

We report a 23-year-old man with suprasellar germinoma accompanied by optic tract syndrome, Horner's syndrome, and trochlear nerve palsy. Neuroimaging demonstrated that the optic tract, the hypothalamus on the left side, and the trochlear nerve in the subarachnoid space were involved by a germinoma. In addition to neuroimaging findings, detailed observation of various ocular symptoms was highly useful for determining the localization of the germinoma.

Isolated Trochlear Nerve Palsy in Tolosa-Hunt Syndrome

“…Regarding various causes of unilateral SOMP, orbital myositis (13,14), thyroid ophthalmopathy (15), trauma (16), surgery (16), cysticercosis (16), peripheral ischemia (16), midbrain stroke (16), congenital (16), multiple sclerosis (17), ophthalmic migraine (18), aneurysm (7,8), cyst (19), neuroborreliosis (20), tumor (9,21), dural carotidcavernous sinus fistula (10), and herpes zoster ophthalmicus (22) have been noted. However, in the present patient, these various causes of unilateral SOMP (7-10, 13-22) could be excluded, based on her clinical course and MR examinations findings.…”