Isolated oculomotor nerve palsy in malignant lymphoma

We report the clinical features of isolated oculomotor nerve palsy in patients with malignant lymphoma. A retrospective evaluation of five patients was performed. Their ages ranged from 43 to 77 years (average: 64.5 years). All histopathologic types were non-Hodgkin's lymphoma, in particular B-cell type in four patients. Oculomotor nerve palsy was unilateral in all five patients and the pupil was spared in four. Leptomeningeal dissemination of malignant lymphoma was detected in three patients. However, neuroimaging could not locate the lesion responsible for the oculomotor nerve palsy in any patient. Despite chemotherapy, all patients died within nine months after the appearance of oculomotor nerve palsy. In malignant lymphoma, isolated oculomotor nerve palsy is unilateral, pupil-sparing, and a poor prognostic sign.