Chronic Myelogenous Leukemia Presenting with Oculomotor Nerve Palsy: A Case Report and Review of Literatures

Amrit Adhikari BK, Dinesh Sangroula, Saad Rahmat, Marie Chevenon

Abstract


Introduction: Chronic myelogenous leukemia (CML), the most common sub-type of leukemia, usually presents with anorexia, fatigue, weight loss, splenomegaly, infection, and bleeding diasthesis. Cranial nerve palsy is a rare occurrence with myelo-proliferative disorder. Though prior literatures reported cranial neuropathies with different myelo-proliferative disorders, commonly acute leukemias and lymphomas, this is the first case of CML presenting with oculomotor nerve palsy.

Presentation of case: We report a 55-year old African American male presented in emergency department with features of third cranial nerve palsy, including unilateral ptosis, diplopia, and downward-outward deviation of eyeball without involvement of pupil. Clinical suspicion of CML, based on preliminary routine laboratory investigation, was confirmed by bone marrow biopsy and genetic testing of marrow aspirate. Patient was treated with Imatinib and regularly followed up with complete blood count.

Conclusion: CML may present with lone cranial nerve palsy as the first clinical finding. Hence, we emphasize to consider leukemia as one of the possible differential diagnoses in suspected patients presenting with isolated oculomotor palsy, if no other cause is evident.


Keywords


Chronic Myelogenous Leukemia; CML; Oculomotor Nerve; Palsy

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References


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