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Case Reports
. 2025 Apr 30:5:1525183.
doi: 10.3389/fopht.2025.1525183. eCollection 2025.

Isolated third cranial nerve palsy as the presenting sign of tuberculum sellae meningioma: a case report

Azizah Alotaibi  1 , Fay Althunayyan  2 , Shuroq Alshehri  1 , Hosam Al-Jehani  1   3   4
Affiliations
Case Reports

Isolated third cranial nerve palsy as the presenting sign of tuberculum sellae meningioma: a case report

Azizah Alotaibi et al. Front Ophthalmol (Lausanne). .

Abstract

Tuberculum sellae meningioma (TSM) is an uncommon tumor among all intracranial meningiomas. As these tumors grow, they compress the surrounding structures, including the optic nerves and the pituitary gland. Ocular motor nerve palsy (OMNP) can occur as an isolated mononeuropathy or as part of multiple cranial nerve palsies. The role of corticosteroids in the management of OMNP has not been fully studied in the literature. In this report, we present a case of a previously well middle-aged woman who presented with severe headache and isolated OMNP on examination. MRI of the brain showed a small TSM that extends into the right optic canal. In our case, we noted the expedient and complete recovery of isolated OMNP within a few days following treatment with dexamethasone. This case report is on an isolated OMNP associated with TSM, which has not been previously reported. In addition, it highlights the role of corticosteroids in achieving rapid recovery from OMNP.

Keywords: corticosteroids; meningioma; neurophthalmology; oculomotor nerve; tuberculum sellae meningioma.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) Axial, (B) coronal, and (C) sagittal contrasted MRI showing a small (0.8x0.8 cm) tuberculum sellae meningioma that extends into the right optic canal.
Figure 2
Figure 2
Coronal contrasted MRI showing no involvement of the cavernous sinus.
See this image and copyright information in PMC

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