scholarly journals Cephalic Tetanus from Penetrating Orbital Wound

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Eloïse Guyennet ◽  
Jean-Laurent Guyomard ◽  
Emilie Barnay ◽  
Franck Jegoux ◽  
Jean-François Charlin
Keyword(s):  
Nerve Palsy ◽  
Cranial Nerves ◽  
Facial Trauma ◽  
Clostridium Tetani ◽  
Neurologic Disorder ◽  
Protein Toxin ◽  
Wooden Foreign Body ◽  
Cephalic Tetanus ◽  
The Right ◽  
Complete Ophthalmoplegia

Tetanus is a neurologic disorder caused by tetanospasmin, a protein toxin elaborated by Clostridium tetani. Cephalic tetanus is a localized form of the disease causing trismus and dysfunction of cranial nerves. We report the case of a man who presented with facial trauma, complete ophthalmoplegia, exophthalmos, areactive mydriasis, and periorbital hematoma. An orbital CT revealed air bubbles in the right orbital apex. The patient was given a tetanus toxoid booster and antibiotherapy. After extraction of a wooden foreign body, the patient developed right facial nerve palsy, disorders of swallowing, contralateral III cranial nerve palsy, and trismus. Only one case of cephalic tetanus from penetrating orbital wound has been reported in literature 20 years ago. When a patient presents with an orbital wound with ophthalmoplegia and signs of anaerobic infection, cephalic tetanus should be ruled out.

scholarly journals Cephalic tetanus manifesting as isolated facial nerve palsy- a case report from rural Armenia

2021 ◽  
Vol 15 (11) ◽  
pp. 1770-1773
Author(s):  
Armen Kishmiryan ◽  
Jeevan Gautam ◽  
Deeksha Acharya ◽  
Bishnu Mohan Singh ◽  
Armen Ohanyan ◽  
...  
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Early Recognition ◽  
Cranial Nerves ◽  
Tetanus Antitoxin ◽  
The Face ◽  
Cephalic Tetanus ◽  
Initiation Of Therapy

Cephalic tetanus is a rare clinical form of tetanus, clinically characterized by trismus and cranial nerve palsy involving one or more cranial nerves, facial nerve being the most common. We report a case of cephalic tetanus with left-sided lower motor facial nerve palsy in a 66-year-old non-immunized patient after an untreated laceration injury. The patient had dysphagia, spasm of the muscles of mastication, asymmetry of the left side of the face, cough, shortness of breath, and stiffness of neck muscles. The presentation was unique given that the facial nerve palsy appeared prior to the occurrence of trismus, which misled the initial diagnosis towards Bell's palsy. He was successfully treated with tetanus antitoxin without any adverse events. Although widespread use of tetanus vaccine has led to a dramatic decline in this fatal disease, sporadic disease occurrence is still possible, particularly in individuals without up-to-date vaccinations. In this case report we illustrate the importance of early recognition of cephalic tetanus prior to the development of the full clinical picture. The early initiation of therapy is the key to recovery from this deadly disease. Physicians are encouraged to include cephalic tetanus as a cause of facial nerve palsy in their differential. In particular, paying attention to cases manifesting early after head or neck injury.

scholarly journals Opthalmoplegic Migrane with Recurrent Sixth Nerve Palsy: A Rare Presentation of Headache in a Young Lady

1970 ◽  
Vol 10 (2) ◽  
pp. 139-141
Author(s):  
Monzurul H Chowdhury ◽  
Zannatun Nur ◽  
Hosne Ara Begum ◽  
Md Shahriar Mahbub ◽  
HAM Nazmul Ahasan
Keyword(s):  
Nerve Palsy ◽  
Cranial Nerves ◽  
Abducens Nerve ◽  
Young Lady ◽  
Double Vision ◽  
Rare Presentation ◽  
Third Nerve Palsy ◽  
Sixth Nerve Palsy ◽  
The Right ◽  
Sixth Nerve

Migraine is a common presentation of headache but migraine with opthalmoplegia with third nerve palsy is rare and with fourth or sixth nerve palsy is very rare. Although it represents a benign course, duration and severity are variable among the patients. We demonstrated a young lady presenting with right hemicranial headache for 12 days with several episodes of vomiting. She also complained of double vision for 7 days. The headache started from the inner canthus of right eye and gradually spread throughout the right half of head over 2 hours and was throbbing in nature. She also complained of double vision from 5th day after onset of headache. Interestingly, she informed similar types of attack for two episodes in last 1 year which persisted for around 22-25 days each time. On examination, she appeared ill looking with convergent squint on right lateral gaze. Cranial nerves examinations showed all the cranial nerves were intact except right sixth cranial nerve palsy. Laboratory investigations and neuroimaging were normal. Our case fulfilled the International Classification of Headache Disorders (ICHD II) criteria for opthalmoplegic migraine with recurrent six nerve palsy which responded dramatically with prednisolone therapy 1mg/kg/day which also prevented recurrence within 6 months. Keyword: Migraine, Opthalmoplegic migraine, Abducens nerve palsy.   doi: 10.3329/jom.v10i2.2833   J MEDICINE 2009; 10 : 139-141

Pituitary adenoma presenting as acute onset isolated complete third cranial nerve palsy without vision changes

2020 ◽  
Vol 13 (6) ◽  
pp. e232490
Author(s):  
Divya Natarajan ◽  
Suresh Tatineni ◽  
Srinivasa Perraju Ponnapalli ◽  
Virender Sachdeva
Keyword(s):  
Pituitary Adenoma ◽  
Cavernous Sinus ◽  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Nerve Palsy ◽  
Cranial Nerves ◽  
Lateral Spread ◽  
Automated Perimetry ◽  
Third Cranial Nerve Palsy ◽  
The Right

We report a case of isolated unilateral complete pupil involving third cranial nerve palsy due to pituitary adenoma with parasellar extension into the right cavernous sinus. The patient was referred to us from neurosurgery with sudden onset binocular vertical diplopia with complete ptosis, and mild right-sided headache of 5-day duration. Ocular examination revealed pupil involving third cranial nerve palsy in right eye while rest of the examination including automated perimetry was normal. MRI brain with contrast revealed a mass lesion with heterogenous enhancement in the sella suggestive of a pituitary macroadenoma with possible internal haemorrhage (apoplexy). In addition, the MRI showed lateral spread to the right cavernous sinus which was causing compression of the right third cranial nerve. The patient was systemically stable. This report highlights a unique case as the lesion showed a lateral spread of pituitary adenoma without compression of the optic chiasm or other cranial nerves.

scholarly journals Chondroma in the hypoglossal canal: A case report

2019 ◽  
Vol 10 ◽  
pp. 63
Author(s):  
Shintaro Arai ◽  
Katsuyoshi Shimizu ◽  
Tohru Mizutani
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Nerve Palsy ◽  
Hypoglossal Nerve ◽  
Cranial Nerves ◽  
Case Description ◽  
Functional Impairments ◽  
Hypoglossal Canal ◽  
Nerve Dysfunction ◽  
The Right

Background: Intracranial chondromas are rare tumors arising from the skull base. They are usually accompanied by functional impairments of some cranial nerves. However, hypoglossal nerve dysfunction is rare. Case Description: We report on a 57-year-old woman presenting with chondroma of the right hypoglossal canal leading to right hypoglossal nerve palsy. Conclusions: This report suggests that chondroma should be considered as a differential diagnosis in cases of hypoglossal lesions.

Left suboccipital supracerebellar transtentorial approach for resection of tectal cavernous malformation

2019 ◽  
Vol 1 (2) ◽  
pp. V19
Author(s):  
Hussam Abou-Al-Shaar ◽  
Timothy G. White ◽  
Ivo Peto ◽  
Amir R. Dehdashti
Keyword(s):  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Entry Zone ◽  
Third Nerve Palsy ◽  
History Of ◽  
Tectal Plate ◽  
The Right ◽  
Transtentorial Approach ◽  
Third Nerve

A 64-year-old man with a midbrain cavernoma and prior bleeding presented with a 1-week history of diplopia, partial left oculomotor nerve palsy, and worsening dysmetria and right-sided weakness. MRI revealed a hemorrhagic left tectal plate and midbrain cavernoma. A left suboccipital supracerebellar transtentorial approach in the sitting position was performed for resection of his lesion utilizing the lateral mesencephalic sulcus safe entry zone. Postoperatively, he developed a partial right oculomotor nerve palsy; imaging depicted complete resection of the cavernoma. He recovered from the right third nerve palsy, weakness, and dysmetria, with significant improvement of his partial left third nerve palsy.The video can be found here: https://youtu.be/ofj8zFWNUGU.

scholarly journals Gasperini Syndrome: A Case Report and Systematic Review and Proposing a New Definition

2020 ◽  
Vol 12 (3) ◽  
pp. 433-439
Author(s):  
Riwaj Bhagat ◽  
Siddharth Narayanan ◽  
Marwa Elnazeir ◽  
Thong Diep Pham ◽  
Robert Paul Friedland ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Mri ◽  
Cranial Nerves ◽  
Clinical Manifestations ◽  
The Other ◽  
Neurological Deficits ◽  
Brainstem Stroke ◽  
Neurological Features ◽  
The Right ◽  
Core Features

Gasperini syndrome (GS), a rare brainstem syndrome, is featured by ipsilateral cranial nerves (CN) V–VIII dysfunction with contralateral hemibody hypoesthesia. While there have been 18 reported cases, the GS definition remains ambiguous. We report a new case and reviewed the clinical features of this syndrome from all published reports to propose a new definition. A 57-year-old man with acute brainstem stroke had right CN V–VIII and XII palsies, left body hypoesthesia and ataxia. Brain MRI showed an acute stroke in the right caudal pons and bilateral cerebellum. After a systematic review, we classified the clinical manifestations into core and associate features based on the frequencies of occurring neurological deficits. We propose that a definitive GS requires the presence of ipsilateral CN VI and VII palsies, plus one or more of the other three core features (ipsilateral CN V, VIII palsies and contralateral hemibody hemihypalgesia). Additionally, GS, similar to Wallenberg’s syndrome, represents a spectrum that can have other associated neurological features. The revised definition presented in this study may enlighten physicians with the immediate recognition of the syndrome and help improve clinical localization of the lesions and its management.

scholarly journals Intraorbital wooden foreign body detected by computed tomography and magnetic resonance imaging

2016 ◽  
Vol 30 (1) ◽  
pp. 88-91 ◽  
Author(s):  
Alfredo Di Gaeta ◽  
Francesco Giurazza ◽  
Eugenio Capobianco ◽  
Alvaro Diano ◽  
Mario Muto
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Magnetic Resonance ◽  
Delayed Diagnosis ◽  
Clinical History ◽  
Definitive Diagnosis ◽  
Double Vision ◽  
Resonance Imaging ◽  
Wooden Foreign Body ◽  
The Right

To identify and localize an intraorbital wooden foreign body is often a challenging radiological issue; delayed diagnosis can lead to serious adverse complications. Preliminary radiographic interpretations are often integrated with computed tomography and magnetic resonance, which play a crucial role in reaching the correct definitive diagnosis. We report on a 40 years old male complaining of pain in the right orbit referred to our hospital for evaluation of eyeball pain and double vision with an unclear clinical history. Computed tomography and magnetic resonance scans supposed the presence of an abscess caused by a foreign intraorbital body, confirmed by surgical findings.

scholarly journals Extreme Lateral Supracerebellar Infratentorial Approach to the Lateral Midbrain

2018 ◽  
Vol 79 (S 05) ◽  
pp. S415-S417
Author(s):  
M. Kalani ◽  
William Couldwell
Keyword(s):  
Cranial Nerves ◽  
Sudden Onset ◽  
Superior Cerebellar Artery ◽  
Entry Zone ◽  
Cerebellar Artery ◽  
Sensory Disturbances ◽  
History Of ◽  
Supracerebellar Infratentorial Approach ◽  
The Right ◽  
Piecemeal Resection

This video illustrates the case of a 52-year-old man with a history of multiple bleeds from a lateral midbrain cerebral cavernous malformation, who presented with sudden-onset headache, gait instability, and left-sided motor and sensory disturbances. This lesion was eccentric to the right side and was located in the dorsolateral brainstem. Therefore, the lesion was approached via a right-sided extreme lateral supracerebellar infratentorial (exSCIT) craniotomy with monitoring of the cranial nerves. This video demonstrates the utility of the exSCIT for resection of dorsolateral brainstem lesions and how this approach gives the surgeon ready access to the supracerebellar space, and cerebellopontine angle cistern. The lateral mesencephalic safe entry zone can be accessed from this approach; it is identified by the intersection of branches of the superior cerebellar artery and the fourth cranial nerve with the vein of the lateral mesencephalic sulcus. The technique of piecemeal resection of the lesion from the brainstem is presented. Careful patient selection and respect for normal anatomy are of paramount importance in obtaining excellent outcomes in operations within or adjacent to the brainstem.The link to the video can be found at: https://youtu.be/aIw-O2Ryleg.

Isolated Congenital Absence of Cranial Nerves: Report of Two Cases

2018 ◽  
Vol 49 (06) ◽  
pp. 405-407
Author(s):  
Vivek Agarwal ◽  
Sumeet Dhawan ◽  
Naveen Sankhyan ◽  
Sameer Vyas
Keyword(s):  
High Resolution ◽  
Mr Imaging ◽  
Cranial Nerve ◽  
Clinical Presentation ◽  
Cranial Nerves ◽  
Rare Condition ◽  
Congenital Absence ◽  
The Third ◽  
Seventh Cranial Nerve ◽  
The Right

AbstractIsolated cranial nerve absence is a rare condition that can be diagnosed using high-resolution cranial nerve magnetic resonance (MR) imaging. Thorough clinical examination with proper knowledge of the course of cranial nerves may help diagnose this rare condition. We describe two cases, one each of, isolated congenital absence of the third and seventh cranial nerve with their clinical presentation. High-resolution T2-weighted MR imaging was done in both patients which revealed absence of cisternal segment of the right-sided third nerve and cisternal with canalicular segment of the right-sided facial nerve.

scholarly journals Internal Carotid Artery dissection presenting as Isolated Hypoglossal nerve palsy

2009 ◽  
Vol 8 (1) ◽  
pp. 22-25
Author(s):  
Amir Ahmad ◽  
◽  
Amir Ahmad ◽  
Philip Travis ◽  
Mark Doran ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
Internal Carotid ◽  
Cranial Nerves ◽  
Carotid Artery Dissection ◽  
Artery Dissection ◽  
Internal Carotid Artery Dissection ◽  
Cranial Nerve Palsies

Internal carotid dissection most commonly presents as headache, focal neurological deficits or stroke. Rarely it can manifest itself by causing a palsy of the lower cranial nerves (IX, X, XI, XII). The reported incidence of isolated cranial nerve palsies is rare. We report a case of an internal carotid artery dissection manifesting as isolated XII (hypoglossal) cranial nerve palsy.

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