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.
References
Aboukais R, Zairi F, Baroncini M, Bonne NX, Schapira S, Vincent C, Lejeune JP (2013) Intracranial meningiomas and neurofibromatosis type 2. Acta Neurochir (Wien) 155:997–1001
Barrett VJ, Tan MH, Elston JS (2012) Recurrent third nerve palsy as the presenting feature of neurofibromatosis 2. J Neuroophthalmol 32:329–331
Gokce G, Ceylan OM, Altinsoy HI (2013) Recurrent alternating oculomotor nerve palsy: an unusual presentation of parasagittal meningioma. Neuro-Ophthalmology 37:82–85
Goutagny S, Kalamarides M (2010) Meningiomas and neurofibromatosis. J Neurooncol 99:341–347
Prasad M, Choi J, Baxter P (2014) Recurrent third nerve palsy as the presenting feature of neurofibromatosis 2. J Neuroophthalmol 34:102–103
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Gokce, G., Ceylan, O.M., Mutlu, F.M. et al. Intracranial meningiomas and neurofibromatosis type 2. Acta Neurochir 156, 1103 (2014). https://doi.org/10.1007/s00701-014-2069-x
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DOI: https://doi.org/10.1007/s00701-014-2069-x