Third cranial nerve palsy: An unusual presentation of cytarabine toxicity

Abstract

A 62-year-old male presented with pupil-sparing third cranial nerve palsy. He was not a known case of diabetes mellitus or hypertension. The patient was on cytarabine as a part of treatment for acute lymphoblastic leukaemia (ALL). There was no other neurological finding. Magnetic resonance imaging with contrast and magnetic resonance angiogram was normal. The major side effects of cytarabine are limited to the gastrointestinal system and bone marrow. While with high doses, cerebellar neurotoxicity is seen, peripheral neurotoxicity is relatively uncommon. This case report describes a unique case of peripheral neuropathy in the form of third cranial nerve palsy due to cytarabine toxicity and its management.