A Case of Germinoma Presenting with Pupil-involving Isolated Oculomotor Nerve Palsy

In patients with pupil-involving isolated oculomotor nerve palsy (IOP), compressive lesions, meningitis, and midbrain infarction can usually be excluded if the responsible lesions are not verified on a brain MRI, catheter angiography, and cerebrospinal fluid examination. However, we experienced a 11-year-old boy with pupil-involving IOP whose initial investigations had been normal and whose symptoms had been stationary over 3 months but was eventually confirmed to have germinoma. This case suggests that a patient with IOP without improvement for a prolonged period needs re-evaluation regardless of normal initial investigations. (J Korean Neurol Assoc 19(4):423~426, 2001)