Cranial nerve involvement in patients with MOG antibody–associated disease

ObjectiveTo describe clinical and radiologic features of cranial nerve (CN) involvement in patients with myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) and to assess the potential underlying mechanism of CN involvement using a nonhuman primate (NHP) model.MethodsEpidemiologic, clinical, and radiologic features from a national cohort of 273 MOG-IgG–positive patients were retrospectively reviewed for CN involvement between January 2014 and January 2018. MOG-IgG binding was evaluated in CNS, CN, and peripheral nerve tissues from NHP.ResultsWe identified 3 MOG-IgG–positive patients with radiologic and/or clinical CN involvement. Two patients displayed either trigeminal or vestibulocochlear nerve lesions at the root level, and the remaining patient had an oculomotor nerve involvement at the root exit and at the cisternal level. Additional CNS involvement was found in all 3 patients. None of the 3 patients' sera recognized MOG expression in CN of NHP.ConclusionCraneal nerve involvement can coexist in patients with MOG antibody disease, although the underlying pathophysiology remains elusive.

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Clinical Presentations and Outcome Studies of Cranial Nerve Involvement in Herpes Zoster Infection: A Retrospective Single-Center Analysis

Journal of Clinical Medicine ◽

10.3390/jcm9040946 ◽

2020 ◽

Vol 9 (4) ◽

pp. 946 ◽

Cited By ~ 1

Author(s):

Po-Wei Tsau ◽

Ming-Feng Liao ◽

Jung-Lung Hsu ◽

Hui-Ching Hsu ◽

Chi-Hao Peng ◽

...

Keyword(s):

Herpes Zoster ◽

Cranial Nerve ◽

Cranial Nerves ◽

Skin Lesions ◽

Motor Symptoms ◽

Herpes Zoster Infection ◽

Cranial Nerve Involvement ◽

Vestibulocochlear Nerve ◽

Nerve Involvement ◽

Clinical Presentations

Varicella-zoster virus (VZV) infection can cause chickenpox and herpes zoster. It sometimes involves cranial nerves, and rarely, it can involve multiple cranial nerves. We aimed to study clinical presentations of cranial nerve involvement in herpes zoster infection. We included patients who had the diagnosis of herpes zoster infection and cranial nerve involvement. The diagnosis was confirmed by typical vesicles and a rash. We excluded patients who had cranial neuralgias or neuropathies but without typical skin lesions (zoster sine herpete or post-herpetic neuralgia). We included 330 patients (mean age, 55.0 ± 17.0 years) who had herpes zoster with cranial nerve involvement, including 155 men and 175 women. Most frequently involved cranial nerves were the trigeminal nerve (57.9%), facial nerve (52.1%), and vestibulocochlear nerve (20.0%). Other involved cranial nerves included the glossopharyngeal nerve (0.9%), vagus nerve (0.9%), oculomotor nerve, trochlear nerve, and abducens nerve (each 0.3%, respectively). One hundred and seventy patients (51.5%) had only sensory symptoms/signs; in contrast, 160 patients (48.5%) had both sensory and motor symptoms/signs. Of those 160 patients, sensory preceded motor symptoms/signs in 64 patients (40.0%), sensory and motor symptoms/signs occurred simultaneously in 38 patients (23.8%), and motor preceded sensory symptoms/signs in 20 patients (12.5%). At one month after herpes zoster infection, vesicles and rash disappeared in 92.6% of patients; meanwhile facial palsy showed a significant improvement in 81.4% of patients (p < 0.05). Cranial motor neuropathies are not infrequent in herpes zoster infections. Multiple cranial nerve involvement frequently occurred in Ramsay Hunt syndrome. We found a significantly increased seasonal occurrence of cranial nerve zoster in spring rather than summer. Cranial motor nerves were affected while the hosts sometimes had a compromised immune system.

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

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.145200 ◽

2014 ◽

Vol 05 (S 01) ◽

pp. S043-S047 ◽

Cited By ~ 5

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.

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