scholarly journals COVID-19 associated cranial nerve neuropathy: A systematic review

2021 ◽  
Author(s):  
Josef Finsterer ◽  
Fulvio Alexandre Scorza ◽  
Carla Scorza ◽  
Ana Fiorini
Keyword(s):  
Systematic Review ◽  
Peripheral Nerves ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
Complete Recovery ◽  
Intravenous Immunoglobulins ◽  
Partial Recovery ◽  
Cranial Nerve Involvement ◽  
Lethal Outcome ◽  
Nerve Involvement

The involvement of cranial nerves is being increasingly recognised in COVID-19. This review aims to summarize and discuss the recent advances concerning the clinical presentation, pathophysiology, diagnosis, treatment, and outcomes of SARS-CoV-2 associated cranial nerve mononeuropathies or polyneuropathies. Therefore, a systematic review of articles from PubMed and Google Scholar was conducted. Altogether 36 articles regarding SARS-CoV-2 associated neuropathy of cranial nerves describing 56 patients were retrieved. Out of these 56 patients, cranial nerves were compromised without the involvement of peripheral nerves in 32 of the patients, while Guillain-Barre syndrome (GBS) with cranial nerve involvement was described in 24 patients. A single cranial nerve was involved either unilaterally or bilaterally in 36 patients, while in 19 patients multiple cranial nerves were involved. Bilateral involvement was more prevalent in the GBS group (n=11) as compared to the cohort with isolated cranial nerve involvement (n=5). Treatment of cranial nerve neuropathy included steroids (n=18), intravenous immunoglobulins (IVIG) (n=18), acyclovir/valacyclovir (n=3), and plasma exchange (n=1). The outcome was classified as “complete recovery” in 21 patients and as ”partial recovery” in 30 patients. One patient had a lethal outcome. In conclusion, any cranial nerve can be involved in COVID-19, but cranial nerves VII, VI, and III are the most frequently affected. The involvement of cranial nerves in COVID-19 may or may not be associated with GBS. In patients with cranial nerve involvement, COVID-19 infections are usually mild. Isolated cranial nerve palsy without GBS usually responds favorably to steroids. Cranial nerve involvement with GBS benefits from IVIG.   

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.

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.

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 Twelfth cranial nerve involvement in Guillian Barre syndrome

2013 ◽  
Vol 04 (03) ◽  
pp. 338-340 ◽  
Author(s):  
Subrat Kumar Nanda ◽  
Sita Jayalakshmi ◽  
Devashish Ruikar ◽  
Mohandas Surath
Keyword(s):  
Cranial Nerve ◽  
Cranial Nerves ◽  
Review Of The Literature ◽  
Cranial Nerve Involvement ◽  
Nerve Involvement

ABSTRACTGuillian Barre Syndrome (GBS) is associated with cranial nerve involvement. Commonest cranial nerves involved were the facial and bulbar (IXth and Xth). Involvement of twelfth cranial nerve is rare in GBS. We present a case of GBS in a thirteen years old boy who developed severe tongue weakness and wasting at two weeks after the onset of GBS. The wasting and weakness of tongue improved at three months of follow up. Brief review of the literature about XIIth cranial nerve involvement in GBS is discussed.

scholarly journals Chronic inflammatory demyelinating polyneuropathy with hypoglossal nerve involvement and inverted Beevor’s sign: case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huajian Zhao ◽  
Yiming Zheng ◽  
Lingchao Meng ◽  
Meng Yu ◽  
Wei Zhang ◽  
...  
Keyword(s):  
Cranial Nerve ◽  
Hypoglossal Nerve ◽  
Chronic Inflammatory Demyelinating Polyneuropathy ◽  
Cranial Nerves ◽  
Sensory Impairment ◽  
Cranial Nerve Involvement ◽  
Limb Weakness ◽  
Glucocorticoid Treatment ◽  
Case Presentation ◽  
Nerve Involvement

Abstract Background Cranial nerve involvement is not commonly encountered in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP); this is especially true for involvement of the hypoglossal nerve. Neither Beevor's sign nor its inverted form has previously been described in CIDP. Case presentation A 28-year-old man presented with distal-predominant limb weakness and numbness at the age of 18. A diagnosis of CIDP was made, which was confirmed by electrodiagnostic evidence of demyelination. He responded well to intravenous immunoglobulin and glucocorticoid treatment and achieved remission for 5 years. However, the same symptoms relapsed at the age of 28 and lasted for 10 months. On examination, in addition to limb sensory impairment and muscle weakness, mild bilateral facial paresis, tongue atrophy and fasciculations, and inverted Beevor's sign were also observed. A brief literature review of cranial nerve involvements in CIDP and Beevor's sign or its inverted form were also performed. Conclusions Cranial nerves may be affected in patients with CIDP. Facial palsy is most frequently present, while hypoglossal nerve involvement is rare. Inverted Beevor's sign can appear in CIDP patients.

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

2020 ◽  
Vol 9 (4) ◽  
pp. 946 ◽  
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.

A Study of Neurological Deficits in Survived Cases of Diphtheria

2018 ◽  
Vol 2 (S1) ◽  
pp. e000126
Author(s):  
Twinkle Patel ◽  
Chirag Shah
Keyword(s):  
Cranial Nerve ◽  
Early Recognition ◽  
Latency Period ◽  
Neurological Deficits ◽  
Partial Recovery ◽  
Cranial Nerve Involvement ◽  
Limb Weakness ◽  
Nerve Involvement ◽  
Bulbar Palsy ◽  
Ventilator Care

Aims and Objectives: To study the incidence, clinical profile and outcome of children with diphtheritic neuropathy. Methodology: A retrospective study of 26 patients with clinical diagnosis of post diphtheritic neuropathy was done. The records were reviewed and information regarding demographic profile, immunization status, clinical presentation, treatment received (medical &/ or surgical including ventilator care) & the outcome were recorded in pro-forma. The results were tabulated and analysed. All the cases who had whitish grey adherent membrane and evidence of neck swelling or has laboratory confirmed evidence (smear or culture positive cases) were diagnosed as cases of diphtheria and amongst them who developed features of neurological deficits like bulbar palsy, cranial nerve involvement or limb weakness were enrolled for further information amongst the survived cases of diphtheria. Patients with other evident cause for neurological deficit were excluded. During this time period total 138 patients of diphtheria were admitted at our hospital and among them 38 patients expired due to various complications.  Results: Incidence of Diphtheritic neuropathy was 29.8% among survived cases of diphtheria in our study. Median age of presentation was 7 years and Median latency period was 18 days. Among these patients 96% patients were either partially immunised or unimmunized. All of them had features of bulbar palsy. Isolated palatal palsy was most common presentation and was present in 53.84% patients. GBS like illness was present in 4 (15.38%) patients. Cranial nerve involvement was present in 8% of patients. Full recovery was seen in 30.7% and partial recovery was seen in 46.15% of patients. Boys were more in numbers. Conclusion: Diphtheria is a vaccine preventable disease so, routine vaccine administration, prompt diagnosis, early treatment, early administration of ADS and early recognition of complications and treatment of such will reduce associated morbidity and mortality.

scholarly journals Cranial nerve involvement: its role in intracranial tuberculosis

2020 ◽  
Vol 9 (1) ◽  
pp. 196
Author(s):  
Baiakmenlang Synmon ◽  
Ashok Kayal
Keyword(s):  
Neurological Deficit ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
Pulmonary Involvement ◽  
Severe Form ◽  
P Value ◽  
Cranial Nerve Involvement ◽  
Tubercular Meningitis ◽  
Focal Neurological Deficit ◽  
Nerve Involvement

Background: Tubercular meningitis is the most severe form of extra pulmonary involvement. Lack of specific and sensitive test calls for a multi-displinary and combined approach to make the diagnosis at the earliest. Various factors guide us to the etiology of meningoencephalitis but cranial nerve involvement has the highest predictive value.Methods: A prospective study from August 2013 to September 2015 carried in GMCH, Guwahati where 93 patients of intracranial tuberculosis was included.Results: This present   study comprised of 36 females (38.7%) and 57 males (61.3%) with a mean age of   32.3±17.05 and a range of 2-72 years. The typical clinicalfeatures of meningitis was found in 78.6%. Focal neurological deficit and cranial nerve involvement was seen in 40 (43%) and 58 (62.4%) respectively. Among the cranial nerves (CN), the most commonly involved is the 2nd CN seen in 33 (35.5%), followed by 6th (16.1%), 7th (11.8%), 3rd (7.5%), 8th (3.2%), 9th  and 10th, (2.2%) 4th (1.1%) and 5th (1.1%). Six patients developed visual loss and two patients hearing loss as sequelae. The presence of cranial nerve involvement and focal neurological deficit was shown to be associated with a poor prognosis (p value=0.04**, significant; Fisher’s exact test).Conclusions: Bedside clinical examination of patients of meningoencephalitis to detect cranial nerve involvement will definitely help us with the diagnosis and prognosis of tubercular meningitis.

“Fibrous dysplasia” of the skull with complete unilateral cranial nerve involvement

1980 ◽  
Vol 52 (3) ◽  
pp. 404-406 ◽  
Author(s):  
Eduardo Fernandez ◽  
Nicola Colavita ◽  
Massimo Moschini ◽  
Adriano Fileni
Keyword(s):  
Fibrous Dysplasia ◽  
Cranial Nerve ◽  
Cranial Nerves ◽  
Cranial Nerve Involvement ◽  
Content Type ◽  
Nerve Involvement ◽  
The Right ◽  
Base Of The Skull ◽  
Pathological Confirmation ◽  
Fine Print

✓ A 40-year-old man with a slowly progressive unilateral sclerotic process of the base of the skull developed complete involvement of all cranial nerves on the right. Roentgenograms of the skull are interpreted as fibrous dysplasia, but pathological confirmation is lacking.

scholarly journals Neurologic Complications Associated with Sjögren’s Disease: Case Reports and Modern Pathogenic Dilemma

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Michele Colaci ◽  
Giulia Cassone ◽  
Andreina Manfredi ◽  
Marco Sebastiani ◽  
Dilia Giuggioli ◽  
...  
Keyword(s):  
Phrenic Nerve ◽  
Cranial Nerve ◽  
Case Reports ◽  
Correct Diagnosis ◽  
Cranial Nerves ◽  
Neurological Manifestations ◽  
Cranial Nerve Involvement ◽  
Trigeminal Neuropathy ◽  
Nerve Involvement ◽  
Disease Case

Objectives. Sjögren’s syndrome (SS) may be complicated by some neurological manifestations, generally sensory polyneuropathy. Furthermore, involvement of cranial nerves was described as rare complications of SS.Methods. We reported 2 cases: the first one was a 40-year-old woman who developed neuritis of the left optic nerve as presenting symptom few years before the diagnosis of SS; the second was a 54-year-old woman who presented a paralysis of the right phrenic nerve 7 years after the SS onset. An exhaustive review of the literature on patients with cranial or phrenic nerve involvements was also carried out.Results. To the best of our knowledge, our second case represents the first observation of SS-associated phrenic nerve mononeuritis, while optic neuritis represents the most frequent cranial nerve involvement detectable in this connective tissue disease. Trigeminal neuropathy is also frequently reported, whereas neuritis involving the other cranial nerves is quite rare.Conclusions. Cranial nerve injury is a harmful complication of SS, even if less commonly recorded compared to peripheral neuropathy. Neurological manifestations may precede the clinical onset of SS; therefore, in patients with apparently isolated cranial nerve involvement, a correct diagnosis of the underlying SS is often delayed or overlooked entirely; in these instances, standard clinicoserological assessment is recommendable.

Sign in / Sign up

Export Citation Format

Share Document