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Cranial nerve palsies accompanying pituitary tumour.

Kim SH, Lee KC, Kim SH

Department of Neurosurgery, Yonsei University College of Medicine, Yonsei Brain Research Institute, 134 Sudaemoon Gu Shinchon Dong, Seoul, Republic of Korea.

We reviewed 12 patients with pituitary tumour and cranial nerve palsy to analyse the clinical characteristics, the radiographic appearances, and the outcome after surgery. All patients had pathologically nonfunctioning macroadenomas with evidence of apoplexy. The third cranial nerve was the most frequently affected, followed by the sixth and fourth cranial nerves. Third cranial nerve palsy manifested as a symptom sequence comprising mydriasis, followed by limitation of gaze and ptosis. These symptoms recovered in reverse order of development. The time taken for recovery of cranial nerve palsy after surgery was significantly correlated with the length of time between the onset of symptoms and surgery. Pituitary apoplexy appears to be the primary cause of cranial nerve palsy with pituitary tumour. Early surgical intervention is most likely to bring about rapid recovery from cranial nerve dysfunction.

Published 21 November 2007 in J Clin Neurosci, 14(12): 1158-62.
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