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Prolactinoma presenting with intermittent third nerve palsy.

W N Wykes

    The British Journal of Ophthalmology
    |September 1, 1986
    PubMed
    Summary

    A recurrent painful third nerve palsy was diagnosed as a prolactinoma. This pituitary tumor caused the patient's symptoms and required specific medical intervention.

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    Area of Science:

    • Neuro-ophthalmology
    • Endocrinology
    • Neuroradiology

    Background:

    • Third nerve palsy can present with varied etiologies, including compressive lesions.
    • Recurrent cranial nerve palsies warrant thorough investigation to identify underlying causes.

    Observation:

    • A patient experienced recurrent painful third nerve palsy.
    • Initial investigations, including carotid angiography, were unremarkable.
    • High-resolution CT revealed a right parasellar tumor.

    Findings:

    • The parasellar tumor was identified as a prolactinoma based on significantly elevated serum prolactin levels.
    • Prolactin levels were measured at over 22,000 millimicrons/.

    Implications:

    • This case highlights the importance of advanced imaging in diagnosing the cause of recurrent third nerve palsy.
    • Prolactinomas can present with neurological symptoms beyond endocrine dysfunction.
    • Prompt diagnosis and management of prolactinomas are crucial for preventing further complications.

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