Dear Editor,

We read with great interest the study by Aboukais et al. [1] describing the characteristics of intracranial meningiomas and neurofibromatosis type 2 (NF 2). On the basis of our experience, there is another important point that should be mentioned.

Meningiomas are slow-growing tumors, and they are mostly asymptomatic for a patient’s entire life. Meningiomas occur in about half of NF 2 patients, and they are often multiple [4]. Barrett et al. [2] and Prasad et al. [5] reported that recurrent third nerve palsy could be the presenting feature of NF 2. We reported a similar case of a 57-year-old man with recurrent alternating oculomotor nerve palsy secondary to a parasagittal meningioma [3]. It is possible that these high-grade meningiomas related to NF 2 can cause a form of neuromyotonia or meningioma-associated mediators may trigger an inflammatory reaction combined with vasculopathy leading to oculomotor neuropathy. We recommend that all NF2 patients should be investigated to diagnose a possible oculomotor nerve disorder secondary to meningioma in the follow-up period.