Isolated oculomotor nerve palsy as the presenting clinical manifestation of a meningeal carcinomatosis: a case report.
We present a previously unreported case of isolated oculomotor nerve palsy as the inaugural clinical sign of meningeal carcinomatosis (MC). Gadolinium-enhanced magnetic resonance images (MRI) were unremarkable. Cerebrospinal fluid (CSF) analysis showed malignant cells consistent with a pulmonary adenocarcinoma; the chest CT revealed a small pulmonary mass in the upper right lobe. This case highlights the importance of considering MC in all patients who develop sudden oculomotor palsy; lumbar punctures should always be performed on patients with normal MRI when other possible causes of oculomotor palsy have been ruled out.
Nardone
R
R
Department of Neurology, F. Tappeiner Hospital, Via Rossini 5, I-39012, Merano (BZ), Italy. raffaele.nardone@asbmeran-o.it
Herz
M
M
Egarter-Vigl
E
E
Tezzon
F
F
D002277:Carcinoma / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008577:Meningeal Neoplasms / Q000134:cerebrospinal fluid / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D015840:Oculomotor Nerve Diseases / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed / Q000379:methods