Intermittent third nerve palsy with cryptococcal meningitis.

In the several days before death, two AIDS patients with cryptococcal meningitis and increased intracranial pressure (ICP) experienced episodic unilateral third nerve palsies seemingly related to transient peaks in ICP. While cryptococcal neuritis may have predisposed the nerves to pressure effects, CT scans showed no evidence of tentorial herniation. These cases raise the possibility that severe elevations of ICP can precipitate third nerve paresis on rare occasions.