LAUSR

A 37-year-old man presented with isolated complete oculo-motor nerve palsy, without other neurological signs. Magnetic resonance imaging (MRI) showed thickening and enhancement of the left third cranial nerve, along with a small nodular lesion in the right cerebellar hemisphere with diffusion restriction ( ► Figure 1 ). Repeated cerebrospinal fl uid analysis eventually con fi rmed the presence of neoplastic cells. Resection of the cerebellar lesion revealed desmoplastic/nodular-type medulloblastoma (MB), sonic hedgehog (SHH)-activated, and TP53 wildtype. The patient was treated with neuroaxis radiotherapy and adjuvant chemotherapy. This case demonstrates a rare presentation of adult MB, highlighting the importance of considering lep-tomeningeal dissemination in the differential diagnosis of isolated cranial neuropathies. 1