Brain & spine
Atypical presentation and behavior of oculomotor schwannoma: case report and literature review
By Leka V, Agastra A, Dodaj S and 5 others.
Abstract
Introduction
Oculomotor nerve schwannomas are rare, particularly in children. Recurrent painful oculomotor palsy may resemble recurrent painful ophthalmoplegic neuropathy (RPON), creating diagnostic uncertainty when an enhancing lesion is present along the nerve. Research question: How should recurrent painful oculomotor palsy be interpreted in a child with a persistent enhancing cisternal lesion, and how can longitudinal observation inform individualized management?
Materials and methods
We report a patient who presented at 13 years of age with painful right oculomotor palsy and a focal enhancing cisternal lesion. The diagnosis was a radiologically diagnosed oculomotor nerve schwannoma; histological confirmation was not obtained. A narrative literature review contextualizes the clinical course and management, with a descriptive comparison of 14 previously reported patients with recurrent or intermittent symptoms.