Isolated Oculomotor Nerve Palsy - A Rare Initial Manifestation of Tuberculous Meningitis.

Tuberculous meningitis (TBM) is a sub-acute / chronic meningitis known for its diverse manifestations which may lead to delayed diagnosis. An isolated oculomotor nerve palsy as an initial presentation of TB meningitis is quite rare. One such case has presented here; A 18 year female presented to us with ptosis of the left eye. Complete neurological examination revealed it to be a case of isolated 3rd cranial nerve palsy. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) brain revealed no significant abnormality. Cerebrospinal fluid (CSF) analysis was done and diagnosis of Tuberculous Meningitis was confirmed. This case report focuses on the fact that tuberculous meningitis should be included in the differential diagnosis of isolated oculomotor nerve palsy.