Diagnostic difficulties in a patient with multiple sclerosis who presents with cranial nerve palsies: an unusual complication of dental work

2020 ◽  
Vol 13 (10) ◽  
pp. e232903
Author(s):  
Jennifer Cathcart ◽  
Rebecca Caitlin Johnson ◽  
Nicholas Hughes ◽  
Manish Patel
Keyword(s):  
Multiple Sclerosis ◽  
Cavernous Sinus ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Unusual Complication ◽  
Cavernous Sinus Thrombosis ◽  
Dental Abscess ◽  
First Case ◽  
Cranial Nerve Palsies ◽  
Diagnostic Difficulties

A woman in her 60s with multiple sclerosis (MS) presented with right-sided ptosis, right sixth nerve palsy, right facial paraesthesia and signs of sepsis. She had a recent diagnosis of a dental abscess. Investigations revealed a right submasseter abscess leading to bacterial meningitis (Streptococcus intermedius) and a cavernous sinus thrombosis. She was managed in intensive care and underwent surgical drainage of the abscess. Anticoagulation for 6 months was planned. Cavernous sinus thrombosis is a very rare complication of a dental abscess, and even less frequently associated with submasseter abscesses. The case was complicated by a history of MS, to which the patient’s symptoms and signs were initially attributed to. This case highlights the diagnostic pitfalls, and aims to enhance learning around similar cases. To the best of our knowledge, this is the first case report of a masseter/submasseter abscess leading to cavernous sinus thrombosis.

scholarly journals Bilateral cavernous sinus thrombosis and facial palsy as complications of dental abscess

2013 ◽  
Vol 4 (2) ◽  
pp. 252 ◽  
Author(s):  
Rajesh Verma ◽  
Vivek Junewar ◽  
RakeshKumar Singh ◽  
Hari Ram ◽  
UmaShanker Pal
Keyword(s):  
Cavernous Sinus ◽  
Facial Palsy ◽  
Sinus Thrombosis ◽  
Cavernous Sinus Thrombosis ◽  
Dental Abscess

scholarly journals Bilateral cavernous sinus thrombosis as first manifestation of primary Burkitt lymphoma of the thyroid gland

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Mehdi Moghaddasi ◽  
Mona Nabovvati ◽  
Saeed Razmeh
Keyword(s):  
Case Report ◽  
Thyroid Gland ◽  
Cavernous Sinus ◽  
Burkitt Lymphoma ◽  
Sinus Thrombosis ◽  
Case Reports ◽  
Rare Condition ◽  
Cavernous Sinus Thrombosis ◽  
First Case ◽  
Clinical Description

Cavernous sinus thrombosis (CST) is a rare condition that is usually associated with infections, pregnancy, vasculitis and some types of medication, such as the contraceptive pill and paraneoplastic. Primary Burkitt lymphoma (PBL) of the thyroid gland is very uncommon and the clinical description of such cases has been largely limited to case reports. In this paper, we present a case of CST as the first manifestation of PBL of the thyroid gland. To the best of our knowledge, our patient is the first case report of PBL of the thyroid gland that presents with bilateral CST.

Recurrent cavernous sinus thrombosis: a rare complication of Cushing disease

2021 ◽  
Vol 14 (6) ◽  
pp. e243786
Author(s):  
Chin Voon Tong ◽  
Chee Kit Tee
Keyword(s):  
Cavernous Sinus ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Pituitary Tumour ◽  
Somatostatin Analogue ◽  
Pituitary Macroadenoma ◽  
Cavernous Sinus Thrombosis ◽  
Pituitary Mass ◽  
Cushing Disease

A 14-year-old girl who presented in 2017 with headache, unilateral right eye ptosis and secondary amenorrhoea had an initial workup consistent with non-functioning pituitary macroadenoma. She underwent debulking of pituitary tumour in October 2017. Postoperatively, she developed recurrent cavernous sinus thrombosis. In view of recurrent thrombosis, she was reinvestigated and was found to have adrenocorticotropic hormone-dependent Cushing. Follow-up MRI 1 year after initial presentation showed that there was structural recurrence of pituitary macroadenoma. She subsequently underwent a petrosal craniotomy for debulking of tumour. Postsurgery she remained biochemically Cushingnoid. MRI 5 months after second surgery showed an enlarging pituitary mass which was deemed inoperable. A multidisciplinary meeting discussion consensus for treatment included radiotherapy and somatostatin analogue, pasireotide. She completed 30 cycles of radiotherapy and MRI post radiotherapy showed reduction in the size of the macroadenoma. Currently, she is waiting for pasereotide initiation.

scholarly journals Horner Syndrome as Complication of Acute Sphenoid Sinusitis

2019 ◽  
Vol 11 (1) ◽  
pp. 112-116 ◽  
Author(s):  
Christoph Käcker ◽  
Franca Wagner ◽  
Marco Caversaccio ◽  
Lukas Anschuetz
Keyword(s):  
Case Report ◽  
Cavernous Sinus ◽  
Nerve Palsy ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Cavernous Sinus Thrombosis ◽  
Horner Syndrome ◽  
Sphenoid Sinusitis

Horner syndrome is described in this case report as a rare complication of bacterial sphenoid sinusitis. A patient presented with miosis, ptosis, and ophthalmic nerve palsy with acute sphenoid sinusistis and cavernous sinus thrombosis on MRI. The impairment of sympathetic fiberscan can be explained through the direct septic effects of the sphenoid sinusitis and indirectly through thrombosis of the cavernous sinus at the level of the carotid plexus.

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