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.

scholarly journals Ramsay Hunt Syndrome with multiple cranial nerve palsy

2012 ◽  
Vol 18 (2) ◽  
pp. 231-233
Author(s):  
KA Al Mahmud ◽  
Kamal Uddin ◽  
Maleka Afroz
Keyword(s):  
Cranial Nerve ◽  
Cranial Nerve Palsy ◽  
Nerve Palsy ◽  
Cranial Nerve Involvement ◽  
Ramsay Hunt Syndrome ◽  
Hunt Syndrome ◽  
Nerve Involvement ◽  
Cranial Nerve Palsies ◽  
Multiple Cranial Nerve Palsy ◽  
Multiple Cranial Nerve

Ramsay Hunt Syndrome classically presents with VII nerve palsy. Other cranial nerve involvement is rare. We describe a case here who presented with VII, IX and X cranial nerve palsies and review the literature. DOI: http://dx.doi.org/10.3329/bjo.v18i2.12029 Bangladesh J Otorhinolaryngol 2012; 18(2): 231-233

scholarly journals Pterygopalatine Fossa: A Way to Spread Mucormycosis with Multiple Cranial Nerve Involvement

2021 ◽  
pp. 1-3
Author(s):  
Masoumeh Eslami ◽  
Masoumeh Eslami
Keyword(s):  
Cranial Nerve ◽  
Chronic Conditions ◽  
Nerve Palsy ◽  
Cranial Nerves ◽  
Pterygopalatine Fossa ◽  
Cranial Nerve Involvement ◽  
Case Presentation ◽  
Nerve Involvement ◽  
Uncontrolled Diabetes ◽  
Multiple Cranial Nerve

Background: Mucormycosis is a rare, aggressive, and fatal infection caused by fungi of the Mucorales order of Zygomycete fungi. Mucormycosis is mainly found in patients with chronic conditions, and clinical cases are observed only in immunocompromised patients and patients with uncontrolled diabetes mellitus. Rhinocerebral type is the most prevalent type of mucormycosis which has a characteristic method of spread. Although the involvement of cranial nerves is not common, it can be multiple with facial nerve involvement. Case Presentation: We described an unusual route of fungus spread in a 50-year-old woman with the involvement of many cranial nerves, without obvious necrosis or significant involvement of paranasal sinuses. Pterygopalatine fossa was a way to spread mucormycosis. Conclusion: In every diabetic patient with cranial nerve palsy and sinusitis, invasive mucormycosis must be considered.

Isolated inflammatory sphenoiditis with multiple unilateral cranial nerve palsies

2006 ◽  
Vol 121 (2) ◽  
pp. 186-188 ◽  
Author(s):  
S Shukla ◽  
S M Keh ◽  
P Andrews ◽  
H Saleh
Keyword(s):  
Cranial Nerve ◽  
Middle Eastern ◽  
Cranial Nerves ◽  
Rare Entity ◽  
Cranial Nerve Involvement ◽  
Nerve Involvement ◽  
Cranial Nerve Palsies ◽  
Abducent Nerve ◽  
Specific Symptoms ◽  
Inflammatory Changes

Isolated sphenoidits is a rare entity that often presents with vague, non-specific symptoms. We present the case of a 36-year-old Middle Eastern man, who developed headache and a painful right eye. A diagnosis of acute sphenoiditis was made. Shortly afterwards, he developed diplopia due to isolated abducent nerve involvement. Within two months, the extent of cranial nerve involvement had increased to include cranial nerves II, III, and V. Subsequently, this was treated by functional endoscopic sinus surgical drainage and biopsy. Histology revealed inflammatory changes. The patient made a dramatic recovery post-operatively, with resolution in all symptoms.

MULTIPLE CRANIAL NERVE PALSIES ASSOCIATED WITH THYROID AUTOIMMUNITY: HASHIMOTO'S THYROIDITIS- A CASE REPORT

2021 ◽  
pp. 51-52
Author(s):  
Neeraja Ponnala ◽  
Stephen Abraham Suresh Kumar ◽  
J.Senthil Nathan
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Cranial Nerve ◽  
Thyroid Autoimmunity ◽  
Cranial Nerves ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Peroxidase ◽  
Cranial Nerve Involvement ◽  
Cognitive Changes ◽  
Cranial Nerve Palsies ◽  
Multiple Cranial Nerve

Hashimotos's encephalopathy is an uncommon neurologic syndrome associated with Hashimoto's thyroiditis. Sometimes it may manifest years before onset of thyroid disease. The patients are usually euthyroid or midly hypothyroid. Antibodies against thyroid peroxidase are useful diagnostic marker of Hashimoto's thyroiditis. High levels of this antibody are associated with high 1 prevalence of hashimoto's encephalopathy . Clinical features are variable includes behavioral and cognitive changes, myoclonus, seizures, hemiparesis, involuntary movements, cerebellar signs, psychosis and coma, with relapsing and progressive course. Diagnosis is often overlooked but it is important as it is treatable cause of encephalopathy. Multiple cranial nerves involvement in Hashimoto's thyroiditis was reported in a very few patients, a rare association. Here we present a case of multiple cranial nerve involvement in a case of hashimoto's thyroiditis.

scholarly journals A study of Guillain–Barré syndrome with reference to cranial neuropathy and its prognostic implication

2014 ◽  
Vol 05 (S 01) ◽  
pp. S043-S047 ◽  
Author(s):  
Amita Bhargava ◽  
Basavaraj F. Banakar ◽  
Guruprasad S. Pujar ◽  
Shubhakaran Khichar
Keyword(s):  
Cranial Nerve ◽  
Nerve Palsy ◽  
Ventilatory Support ◽  
Clinical Profile ◽  
Cranial Neuropathy ◽  
Cranial Nerve Involvement ◽  
Prognostic Implication ◽  
Vestibulocochlear Nerve ◽  
Nerve Involvement ◽  
Cranial Nerve Palsies

ABSTRACT Background: Focused studies on cranial neuropathy in Guillain–Barrι syndrome (GBS) and its prognostic implication are not done previously. Aim: To study the clinical profile of GBS patients with special reference to cranial neuropathy and its prognostic implication. Materials and Methods: The study included 61 patients with GB syndrome, fulfilling Asbury Cornblath’s criteria for GB syndrome. A pre-designed semi-structured questionnaire was used to obtain data regarding demographic profile and clinical profile. All patients underwent detailed neurological examination, investigations including nerve conduction studies and CSF examination and treated according to the severity of the illness. Patients were followed up for 6 months. During analysis two groups were made depending on cranial nerve involvement, and compared with respect to various parameters. Results: Out of 61 patients 38 (62.3%) patients had cranial nerve palsies, in that 25 had multiple cranial nerve palsies, and 13 had single isolated nerve palsy. A majority of 30 (49.2%) had bulbar palsy, 28 (46%) had facial nerve palsy, and all had bilateral involvement except 3 patients who had unilateral palsy. Hypoglossal nerve involvement was seen in six (10%) patients and four (6.5%) patients had ophthalmoplegia. Only one had bilateral vestibulocochlear nerve palsy. On comparing various clinico-electrophysiological parameters among patients of GB syndrome with and without cranial nerve involvement, the presence of respiratory paralysis, IVIg and ventilatory support requirement had significant association with cranial nerve involvement in GBS. Conclusion: Our study found a correlation between cranial nerve palsies and severity of the illness. Cranial nerve innervated muscles recover earlier as compared to distal limb muscles. No association was found between outcome at 6 months and cranial nerve involvement.

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.

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.

scholarly journals Treatment of Ramsay–Huntʼs syndrome with multiple cranial nerve involvement and severe dysphagia

Medicine ◽  
2018 ◽  
Vol 97 (17) ◽  
pp. e0591 ◽  
Author(s):  
Jong Min Kim ◽  
Zeeihn Lee ◽  
Seungwoo Han ◽  
Donghwi Park
Keyword(s):  
Cranial Nerve ◽  
Cranial Nerve Involvement ◽  
Severe Dysphagia ◽  
Nerve Involvement ◽  
Multiple Cranial Nerve

scholarly journals Ophthalmoplegia and cranial nerve deficits in an adolescent with headache

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110244
Author(s):  
Margarita M Corredor ◽  
Peter J Holmberg
Keyword(s):  
Cavernous Sinus ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
Signs And Symptoms ◽  
Inflammatory Condition ◽  
Cranial Nerve Involvement ◽  
Hunt Syndrome ◽  
Nerve Involvement ◽  
Orbital Pain

Tolosa–Hunt syndrome is an idiopathic, inflammatory condition involving the cavernous sinus and is characterized by unilateral, painful ophthalmoparesis. The condition often begins with retro-orbital pain followed by select cranial nerve involvement. We report the case of a 17-year-old female whose presentation with progressive left-sided headache and ophthalmoparesis culminated in the diagnosis of Tolosa–Hunt syndrome. While many of her signs and symptoms have been previously reported in the rare pediatric cases of Tolosa–Hunt syndrome described in the literature, this case illustrates a unique presentation involving cranial nerves V and VII in addition to the more commonly reported cranial nerve III, IV, and VI palsies.

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