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Primary aberrant third nerve regeneration.

D Boghen, J P Chartrand, P Laflamme

    Annals of Neurology
    |November 1, 1979
    PubMed
    Summary
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    Aberrant regeneration of the third cranial nerve, without prior nerve palsy, suggests a cavernous sinus meningioma. This finding is consistent even if other ocular motor nerves are affected.

    Area of Science:

    • Neuroscience
    • Ophthalmology
    • Neurology

    Background:

    • The syndrome of aberrant regeneration of the third cranial nerve (oculomotor nerve) typically follows a third nerve palsy.
    • Understanding the underlying causes and clinical presentations of aberrant regeneration is crucial for accurate diagnosis and management.

    Observation:

    • Presents clinical and neuroradiological features in 4 patients with aberrant regeneration of the third nerve.
    • In these cases, the syndrome was not preceded by third nerve palsy, deviating from common presentations.
    • A petrous apex-cavernous sinus meningioma was identified as the underlying lesion in all four patients.

    Findings:

    • Aberrant regeneration of the oculomotor nerve, particularly when primary, is characteristic of a cavernous sinus meningioma.

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  • This association holds true irrespective of whether other ocular motor nerves are spared or involved.
  • Implications:

    • Suggests that cavernous sinus meningiomas should be considered in the differential diagnosis of aberrant third nerve regeneration, even in the absence of preceding third nerve palsy.
    • Highlights the importance of advanced imaging in identifying meningiomas as the cause of complex cranial nerve syndromes.
    • Contributes to a refined understanding of the neuro-ophthalmological manifestations of meningiomas.