Pituitary apoplexy: A cause for painful third nerve palsy

Abstract

A series of cases of painful third nerve palsy due to pituitary apoplexy is reported to highlight this less recognized cause. Four cases presented with sudden onset of headache associated with an oculomotor nerve palsy. CT scan showed assymmetrical expansion of a pituitary adenoma into the corresponding cavernous sinus in each patient. All palsies recovered spontaneously post transsphenoidal resection of the tumour. The problems associated with the diagnosis of pituitary apoplexy are discussed and the vital role of positive radiological findings is emphasized.

Key Words:

• pituitary apoplexy
• oculomotor nerve
• third nerve palsy