Extraocular motor disturbances in primary brain tumors.

Abstract

The incidence of disorders of involvement of the third, sixth, and fourth cranial nerves in a group of 235 primary brain tumor cases, verified by autopsy, admitted to the Philadelphia General Hospital over a 20-year period was studied. No cases of metastatic tumors, tumors by extension, granulomas, vascular malformations, or subclinical tumors, and no cases admitted within 12 hours of death were included in this survey. There were 157 gliomas, of which over 50% were glioblastoma multiforme. The remaining, nongliogenous group comprised 78 tumors, of which over 60% were meningiomas. Sixty cases showed extraocular motor involvement, most frequently encountered (50% of cases) as unilateral isolated third nerve palsy. Abducens involvement was half as frequent and was also usually unilateral and isolated. No instance of isolated trochlear palsy was reported. Combinations of extraocular motor nerve involvement, more frequently bilateral, occurred in 20% of cases. The brain tumor cases were divided into