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

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 multip...

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Main Authors: Azizah Alotaibi, Fay Althunayyan, Shuroq Alshehri, Hosam Al-Jehani
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Ophthalmology
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Online Access:https://www.frontiersin.org/articles/10.3389/fopht.2025.1525183/full
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author Azizah Alotaibi
Fay Althunayyan
Shuroq Alshehri
Hosam Al-Jehani
Hosam Al-Jehani
Hosam Al-Jehani
author_facet Azizah Alotaibi
Fay Althunayyan
Shuroq Alshehri
Hosam Al-Jehani
Hosam Al-Jehani
Hosam Al-Jehani
author_sort Azizah Alotaibi
collection DOAJ
description 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.
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publishDate 2025-04-01
publisher Frontiers Media S.A.
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series Frontiers in Ophthalmology
spelling doaj-art-e5e04b146f5a43a5a8cbc4a534212d112025-08-20T02:20:12ZengFrontiers Media S.A.Frontiers in Ophthalmology2674-08262025-04-01510.3389/fopht.2025.15251831525183Isolated third cranial nerve palsy as the presenting sign of tuberculum sellae meningioma: a case reportAzizah Alotaibi0Fay Althunayyan1Shuroq Alshehri2Hosam Al-Jehani3Hosam Al-Jehani4Hosam Al-Jehani5Department of Neurosurgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi ArabiaCollege of Medicine, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi ArabiaDepartment of Neurosurgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi ArabiaDepartment of Neurosurgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Al Khobar, Saudi ArabiaDepartment of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University Health Centre, Montreal, QC, CanadaDepartment of Neurosurgery, Weill Cornell University, Houston Methodist, Houston, TX, United StatesTuberculum 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.https://www.frontiersin.org/articles/10.3389/fopht.2025.1525183/fullmeningiomacorticosteroidsoculomotor nervetuberculum sellae meningiomaneurophthalmology
spellingShingle Azizah Alotaibi
Fay Althunayyan
Shuroq Alshehri
Hosam Al-Jehani
Hosam Al-Jehani
Hosam Al-Jehani
Isolated third cranial nerve palsy as the presenting sign of tuberculum sellae meningioma: a case report
Frontiers in Ophthalmology
meningioma
corticosteroids
oculomotor nerve
tuberculum sellae meningioma
neurophthalmology
title Isolated third cranial nerve palsy as the presenting sign of tuberculum sellae meningioma: a case report
title_full Isolated third cranial nerve palsy as the presenting sign of tuberculum sellae meningioma: a case report
title_fullStr Isolated third cranial nerve palsy as the presenting sign of tuberculum sellae meningioma: a case report
title_full_unstemmed Isolated third cranial nerve palsy as the presenting sign of tuberculum sellae meningioma: a case report
title_short Isolated third cranial nerve palsy as the presenting sign of tuberculum sellae meningioma: a case report
title_sort isolated third cranial nerve palsy as the presenting sign of tuberculum sellae meningioma a case report
topic meningioma
corticosteroids
oculomotor nerve
tuberculum sellae meningioma
neurophthalmology
url https://www.frontiersin.org/articles/10.3389/fopht.2025.1525183/full
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