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Related Experiment Videos

Intermittent third nerve palsy with cryptococcal meningitis

J R Keane1

  • 1Department of Neurology, Los Angeles County, University of Southern California Medical Center.

Journal of Clinical Neuro-Ophthalmology
|June 1, 1993
PubMed
Summary
This summary is machine-generated.

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Severe intracranial pressure (ICP) elevations may cause temporary third nerve palsies in AIDS patients with cryptococcal meningitis. These rare events highlight a potential complication of increased ICP in neurological conditions.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Ophthalmology

Background:

  • Cryptococcal meningitis is a serious infection often seen in patients with Acquired Immunodeficiency Syndrome (AIDS).
  • Increased intracranial pressure (ICP) is a known complication of cryptococcal meningitis, potentially leading to severe neurological deficits.
  • Third nerve palsy, affecting eye movement and eyelid function, can occur due to various neurological insults.

Observation:

  • Two AIDS patients with cryptococcal meningitis presented with episodic unilateral third nerve palsies.
  • These neurological events appeared temporally related to transient peaks in intracranial pressure.
  • Computed tomography (CT) scans did not reveal evidence of tentorial herniation in either patient.

Findings:

  • The observed third nerve palsies were potentially precipitated by severe elevations in intracranial pressure.

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  • Cryptococcal neuritis may have increased the susceptibility of the third cranial nerve to pressure-related damage.
  • These cases suggest a rare but possible link between acute ICP spikes and third nerve paresis.

    • Implications:

    • Clinicians should consider the potential for third nerve palsies in AIDS patients with cryptococcal meningitis and elevated ICP.
    • Monitoring ICP and managing pressure fluctuations may be crucial in preventing such neurological complications.
    • This observation expands the understanding of potential neurological manifestations of severe intracranial hypertension.