scholarly journals Herpes zoster oticus with meningitis masquerading as malignant otitis externa

2019 ◽  
Vol 12 (6) ◽  
pp. e229569
Author(s):  
Harriet A Cunniffe ◽  
Nicholas G Cunniffe
Keyword(s):  
Otitis Externa ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Clinical Course ◽  
Abducens Nerve ◽  
Varicella Zoster ◽  
Seventh Cranial Nerve ◽  
Cranial Nerve Palsies ◽  
Malignant Otitis Externa

This is a case of an 85-year-old woman whom was admitted with otalgia and an abducens nerve palsy alongside a Pseudomonas otitis externa; she was presumed to have malignant otitis externa. However, despite optimum treatment and resolution of her otitis externa, she went on to develop an ipsilateral facial nerve palsy and sensorineural hearing loss. After further investigation, it was discovered that varicella-zoster meningitis was causing her polyneuropathy. She eventually responded to antivirals and steroids and, at follow-up, her sixth and seventh cranial nerve palsies had completely resolved, though a hearing deficit remained. This case highlights the importance of keeping a diagnosis under review, with the help of the multidisciplinary team, when the clinical course is not progressing as expected.

scholarly journals A Case Series of Malignant Otitis Externa Mimicking Malignancy

2021 ◽  
Vol 64 (1) ◽  
pp. 36-41
Author(s):  
Vengathajalam Selvamalar ◽  
Nik Adilah Nik Othman ◽  
Mohd Khairi Daud
Keyword(s):  
Cranial Nerve ◽  
Otitis Externa ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Case Series ◽  
Lower Cranial Nerve ◽  
Cortical Mastoidectomy ◽  
Cranial Nerve Palsies ◽  
Adjacent Structures ◽  
Malignant Otitis Externa

Malignant otitis externa is an inflammation of the external auditory canal with preceding osteomyelitis of the temporal bone and the adjacent structures that could be potentially lethal. Malignant otitis externa may present with cranial nerve involvements and massive spread of disease mimicking nasopharyngeal carcinoma or any other malignancies on imaging. Two elderly patients who presented with severe otalgia and significant facial nerve palsy and lower cranial nerve palsies showing extensive spread of disease are reported in this case series. They both had resolution of disease after a prolonged course of antibiotics and cortical mastoidectomy for disease clearance in one of them.

scholarly journals Comprehensive management of malignant otitis externa with tuberculosis and cranial nerve paresis in geriatrics

2020 ◽  
Vol 50 (1) ◽  
pp. 77
Author(s):  
Ratna Dwi Restuti
Keyword(s):  
Diabetes Mellitus ◽  
Temporal Bone ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Otitis Externa ◽  
Nerve Palsy ◽  
Geriatric Patients ◽  
Cranial Nerve Palsies ◽  
Malignant Otitis Externa ◽  
Multiple Cranial Nerve

Background: Malignant otitis externa is an inflammatory condition of the external ear which has the propensity to spread to the skull base. It can be a difficult entity to treat as clinical presentation varies and response to treatment differs between patients. Purpose: Evaluating the management of malignant otitis externa with complications in geriatric patients who had multiple comorbidities. Case: A 71 years old female with a diagnosis of left malignant otitis externa with complications of multiple cranial nerve palsies (N.VII, IX, X) and comorbidity in the form of diabetes mellitus and chronic kidney disease. The patient underwent subtotal temporal bone resection and petrosectomy. Clinical Question: “Could surgical management of malignant otitis externa with cranial nerve palsies complication in geriatric patients with multiple comorbidities achieve better result than conservative treatment?” Review Method: Literature search using keywords ’malignant otitis externa’ OR ’temporal bone osteomyelitis’ AND ’geriatric’ OR ’elderly’ AND ’multiple cranial nerve palsy’ AND ’diabetes mellitus’ AND ’tuberculosis’ AND ’surgery’ OR ’surgical’ was conducted through Cochrane, Pubmed, and Google Scholar. Result: The search obtained 11 articles published in the last 10 years. Selection based on inclusion and exclusion criteria, 2 studies were found relevant with the topic. Conclusion: Management of malignant otitis externa with complications in geriatric patients with multiple comorbidities requires a multidisciplinary approach to determine the need for surgery intervention.Keywords: malignant otitis externa, cranial nerve palsy, subtotal temporal bone resection, geriatric, diabetes mellitus ABSTRAK Latar belakang: Otitis eksterna maligna adalah suatu kondisi peradangan pada telinga luar yang memiliki kecenderungan untuk meluas hingga ke dasar tengkorak. Penyakit ini menjadi sulit ditangani karena manifestasi klinis yang bervariasi dan respons terhadap pengobatan yang berbeda antara pasien. Tujuan: Mengevaluasi tatalaksana otitis eksterna maligna dengan komplikasi pada pasien geriatri yang memiliki komorbiditas multipel. Kasus: Pasien perempuan 71 tahun dengan diagnosis otitis eksterna maligna telinga kiri dengan komplikasi paresis saraf kranial multipel (n.VII, IX, X) dan penyakit penyerta berupa diabetes melitus dan gagal ginjal kronik. Pasien menjalani operasi reseksi tulang temporal subtotal dan petrosektomi. Pertanyaan klinis: “Apakah tatalaksana pembedahan memberikan hasil yang lebih baik dibandingkan terapi konservatif pada pasien geriatri dengan otitis eksterna maligna disertai paresis saraf kranialis dengan komorbiditas multipel.” Telaah Literatur: Dilakukan menggunakan kata kunci ’malignant otitis externa’ ATAU ’temporal bone osteomyelitis’ DAN ’geriatric’ ATAU ’elderly’ DAN ’multiple cranial nerve palsy’ DAN ’diabetes melitus’ DAN ’tuberculosis’ DAN ’surgery’ ATAU ’surgical’ pada beberapa sumber data seperti Cochrane, Pubmed, dan Google Scholar. Hasil: Didapatkan 11 artikel publikasi 10 tahun terakhir. Berdasarkan kriteria inklusi dan eksklusi diperoleh 2 artikel yang relevan dengan topik. Kesimpulan: Tatalaksana otitis eksterna maligna dengan komplikasi pada pasien geriatri dengan komorbiditas multipel, membutuhkan pendekatan multidisiplin terutama untuk menentukan perlunya dilakukan tindakan pembedahan.

Malignant Otitis Externa (MOE) causing cerebral abscess and facial nerve palsy

2010 ◽  
Vol 5 (7) ◽  
pp. E6-E8 ◽  
Author(s):  
John Roberts ◽  
Línea Larson-Williams ◽  
Farrah Ibrahim ◽  
Ali Hassoun
Keyword(s):  
Facial Nerve ◽  
Otitis Externa ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Cerebral Abscess ◽  
Malignant Otitis Externa

Potential association between recurrent facial nerve palsy and migraines

2020 ◽  
Vol 134 (9) ◽  
pp. 822-825
Author(s):  
G Kontorinis ◽  
A Tyagi
Keyword(s):  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Case Series ◽  
Contralateral Side ◽  
Tertiary Referral Centre ◽  
Potential Association ◽  
Motor Neuron Facial Nerve ◽  
Prospective Case Series

AbstractObjectiveThis study aimed to investigate the possible association between recurrent facial nerve palsy and migraines.MethodThis study was a prospective case series with a two-year follow-up at an academic, tertiary referral centre and included patients with at least four episodes of recurrent lower motor neuron facial nerve palsy. All patients underwent standardised diagnostic tests.ResultsFour patients fulfilled the inclusion criteria. The patients were all female with an average age at presentation of 40.75 years (range, 33–60 years) and an average age at the initial episode of 14 years (range, 12–16 years). The number of episodes varied between six and nine. All patients had at least one episode of facial nerve palsy on the contralateral side. Two patients were diagnosed and treated for migraine with aura remaining asymptomatic following prophylactic medication for migraines.ConclusionThe results raise the possibility of an association between recurrent facial nerve palsy and migraines. Prospective studies in patients with even fewer episodes of facial nerve palsy could shed more light on this association.

Case report: facial nerve palsy, necrotising otitis externa and leishmaniasis

2015 ◽  
Vol 46 (2) ◽  
pp. 109-110
Author(s):  
Rushad Patell ◽  
Rupal Dosi ◽  
Rikin Raj ◽  
Shreyans Doshi
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Otitis Externa ◽  
Nerve Palsy ◽  
Facial Nerve Palsy

Abducens Nerve Avulsion and Facial Nerve Palsy After Temporal Bone Fracture: A Rare Concomitance of Injuries

2016 ◽  
Vol 88 ◽  
pp. 689.e5-689.e8 ◽  
Author(s):  
Tej D. Azad ◽  
Anand Veeravagu ◽  
Carleton Eduardo Corrales ◽  
Kevin K. Chow ◽  
Nancy J. Fischbein ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Temporal Bone ◽  
Bone Fracture ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Abducens Nerve ◽  
Temporal Bone Fracture

scholarly journals Tumors Presenting as Multiple Cranial Nerve Palsies

2017 ◽  
Vol 9 (1) ◽  
pp. 54-61 ◽  
Author(s):  
Kishore Kumar ◽  
Rafeeq Ahmed ◽  
Bharat Bajantri ◽  
Amandeep Singh ◽  
Hafsa Abbas ◽  
...  
Keyword(s):  
Cranial Nerve ◽  
Nerve Palsy ◽  
Systemic Disease ◽  
Cranial Nerves ◽  
B Cell Lymphoma ◽  
Abducens Nerve ◽  
Cranial Nerve Involvement ◽  
Nerve Involvement ◽  
Cranial Nerve Palsies ◽  
Multiple Cranial Nerve

Cranial nerve palsy could be one of the presenting features of underlying benign or malignant tumors of the head and neck. The tumor can involve the cranial nerves by local compression, direct infiltration or by paraneoplastic process. Cranial nerve involvement depends on the anatomical course of the cranial nerve and the site of the tumor. Patients may present with single or multiple cranial nerve palsies. Multiple cranial nerve involvement could be sequential or discrete, unilateral or bilateral, painless or painful. The presentation could be acute, subacute or recurrent. Anatomic localization is the first step in the evaluation of these patients. The lesion could be in the brain stem, meninges, base of skull, extracranial or systemic disease itself. We present 3 cases of underlying neoplasms presenting as cranial nerve palsies: a case of glomus tumor presenting as cochlear, glossopharyngeal, vagus and hypoglossal nerve palsies, clivus tumor presenting as abducens nerve palsy, and diffuse large B-cell lymphoma presenting as oculomotor, trochlear, trigeminal and abducens nerve palsies due to paraneoplastic involvement. History and physical examination, imaging, autoantibodies and biopsy if feasible are useful for the diagnosis. Management outcomes depend on the treatment of the underlying tumor.

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