Complete third nerve palsy as a presenting feature of an interpeduncular lipoma

Abstract

Background Intracranial lipomas are rare, benign lesions, of congenital origin commonly found incidentally on imaging studies. Methods We describe a case of interpeduncular lipoma in an 18 year-old female presenting with a painful left complete oculomotor (IIIrd) nerve palsy and associated headache, which to the best of our knowledge has not been reported in an adult patient. Results Following eye patching and steroid treatment, at 6-week follow-up the patient’s pain had significantly improved however the complete IIIrd nerve palsy remained. Conclusions Evidence suggests improvement will occur regardless with conservative management independent of radiological changes to the lipoma.