Third Nerve Palsy in Idiopathic Hypereosinophilic Syndrome: Report of Two Cases

ABSTRACT

The idiopathic hypereosinophilic syndrome (IHES) is a heterogenous spectrum of disorders, characterized by a long lasting hypereosinophilia without identifiable underlying cause and by the presence of various end-organ dysfunction. The neurologic manifestations of IHES can be encephalopathy, organic psycho syndrome and polyneuropathy and in rare cases polymyositis. Central nervous system involvement is the second mostclinically important complication of the hypereosinophilic syndrome as it is associated with chronic disability and a poor prognosis. In this report, we describe two patients of IHES who presented anisolated third nerve palsy with pupillary involvement and were improved by corticosteroid therapy. They satisfied the criteria of IHES and the third cranial nerve was the only site of neurologic involvement. Early recognition of neurologic involvement in IHES and prompt treatment could lead to good outcome: