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Cranial Nerve 10

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9921. Brainstem dysgenesis: report of five patients with congenital hypotonia, multiple cranial nerve involvement, and ocular motor apraxia. (PubMed)

Brainstem dysgenesis: report of five patients with congenital hypotonia, multiple cranial nerve involvement, and ocular motor apraxia. This paper reports three females and two males with a distinctive congenital syndrome characterized by severe congenital hypotonia, facial diplegia, jaw ankylosis, velo-pharyngeal incoordination, pyramidal tract signs, and ocular motor apraxia. Patients were followed up at ages ranging from 20 months to 16 years. All cases of this syndrome are sporadic, without (...) dysmorphological features, chromosomal, or MRI brain abnormalities. Electrophysiological studies indicate the brainstem as the site of the neurological dysfunction. Post-mortem CNS study of one of the patients demonstrated neuronal depletion of the IV, VII, VIII, and IX cranial nerve nuclei and intact morphology of the cerebral hemispheres. A vascular accident, early in foetal life, is the most likely cause of the clinical picture. The extent of brainstem involvement and its related clinical findings

2003 Developmental Medicine and Child Neurology

9922. Bilateral involvement of a single cranial nerve: analysis of 578 cases. (PubMed)

Bilateral involvement of a single cranial nerve: analysis of 578 cases. The author reviewed 34 years of personal experience with inpatients in a large municipal hospital to analyze the seats and causes of involvement of single pairs of cranial nerves. Among 578 cases, the sixth (n = 234) and second (211) nerves predominated, followed by the fourth (48), seventh (30), third (27), and eighth (18) cranial nerves. Trauma (99), infection (94), tumor (92), increased intracranial pressure (85

2005 Neurology

9923. Motor responses of muscles supplied by cranial nerves to subthalamic nucleus deep brain stimuli. (PubMed)

Motor responses of muscles supplied by cranial nerves to subthalamic nucleus deep brain stimuli. The distribution of human corticobulbar motor excitatory and inhibitory output is not fully understood. In particular, it is unclear whether the pattern of innervation is the same for upper and lower facial muscles, and what is the motor cortical area giving rise to such innervation. We used electrodes implanted in the subthalamic nucleus (STN) in patients with Parkinson's disease to activate motor (...) of extraocular muscles. During sustained voluntary muscle contraction, a silent period was recorded at similar onset latency on both sides. This period was significantly shorter in orbicularis oculi than in masseter, and in the ipsilateral side for both muscles (P < 0.01). sSTN-DBS is able to activate the descending projecting fibres in the corticobulbar tract eliciting bilateral MEPs and silent periods in facial and cranial muscles. This suggests that fibres to both ipsi- and contralateral motor nuclei

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2007 Brain

9924. Multiple cranial nerve palsies: analysis of 979 cases. (PubMed)

Multiple cranial nerve palsies: analysis of 979 cases. To my knowledge, no large series of multiple cranial neuropathies is available.To examine the seats and causes of multiple cranial neuropathies in a large group of inpatients.Personal case series.Wards of a large municipal hospital and affiliated rehabilitation hospital.A consecutive series of 979 unselected inpatients with simultaneous or serial involvement of 2 or more different cranial nerves.Cranial nerves VI (565 cases), VII (466 cases (...) ), V (353 cases), and III (339 cases) were most commonly affected. The locations and causes were diverse, with cavernous sinus (252 cases), brainstem (217 cases), and individual nerves (182 cases) being the most frequent sites, and tumor (305 cases), vascular disease (128 cases), trauma (128 cases), infection (102 cases), and the Guillain-Barré and Fisher syndromes (91 cases total) being the most frequent causes. Recurrent cranial neuropathy was uncommon (43 cases, 106 episodes, 136 nerves

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2005 Archives of Neurology

9925. Postinfectious myeloradiculoneuropathy with cranial nerve involvements associated with human herpesvirus 7 infection. (PubMed)

Postinfectious myeloradiculoneuropathy with cranial nerve involvements associated with human herpesvirus 7 infection. Infection with human herpesvirus 7 (HHV-7) generally results in a febrile illness with accompanying exanthema subitum.To ascertain and describe the role of HHV-7 in a case of acute myeloradiculoneuropathy.A previously healthy young man with complaints of motor weakness, dysphasia, and nasal voice.Serological examinations were performed with the patient's serum. We also examined

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2005 Archives of Neurology

9926. Superior divisional third cranial nerve paresis: clinical and anatomical observations of 2 unique cases. (PubMed)

Superior divisional third cranial nerve paresis: clinical and anatomical observations of 2 unique cases. Within the midbrain, the third nerve nucleus is composed of a complex of subnuclei. The fascicular portion of the nerve courses through the red nucleus and exists in the midbrain just medial to the cerebral peduncle. The cisternal portion of the nerve is a single structure that divides into a superior branch and an inferior branch in the region of the cavernous sinus and superior orbital (...) fissure.To describe 2 patients with superior divisional third cranial nerve paresis resulting from a lesion involving the cisternal portion of the nerve prior to its anatomical bifurcation.Case 1 was a 77-year-old man with a superior divisional third nerve palsy as the presenting manifestation of a posterior communicating artery aneurysm. Case 2 was a 41-year-old woman who developed a superior divisional third nerve palsy following anterior temporal lobectomy for epilepsy.In both cases, the presumed

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2006 Archives of Neurology

9927. Anti-GQ1b-negative Miller-Fisher syndrome with lower cranial nerve involvement from parasinusoidal aspergilloma. (PubMed)

Anti-GQ1b-negative Miller-Fisher syndrome with lower cranial nerve involvement from parasinusoidal aspergilloma. Miller-Fisher syndrome (MFS) typically presents with ophthalmoplegia, ataxia, and areflexia. Atypical MFS additionally includes bulbar impairment, affection of the limbs, or abortive presentations. Mostly, MFS follows an infection with Campylobacter jejunii. Aspergilloma has not been reported to trigger MFS. In a 48-year-old male tiredness, tinnitus, otalgia, parietal hyperaesthesia (...) chronic sinusitis maxillaris from an aspergilloma. After immunoglobulins and resectioning of the aspergilloma, neurological abnormalities disappeared within 19d. MFS may manifest as unilateral lower cranial nerve lesions without affection of the upper cranial nerves or ataxia. Atypical MFS may be triggered by parasinusoidal aspergilloma.

2006 Journal of Infection

9928. Isolated inflammatory sphenoiditis with multiple unilateral cranial nerve palsies. (PubMed)

Isolated inflammatory sphenoiditis with multiple unilateral cranial nerve palsies. 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.

2007 Journal of Laryngology & Otology

9929. Hearing preservation and facial nerve outcomes in vestibular schwannoma surgery: results using the middle cranial fossa approach. (PubMed)

Hearing preservation and facial nerve outcomes in vestibular schwannoma surgery: results using the middle cranial fossa approach. To evaluate surgical results using the middle cranial fossa approach for hearing preservation vestibular schwannoma surgery.Retrospective case review.Tertiary referral academic center.Seventy-three consecutive patients with vestibular schwannoma operated on using the middle cranial fossa approach between February 1999 and February 2005.The tumors were removed via (...) the middle cranial fossa approach with modifications to improve exposure. Standard auditory brainstem and facial nerve monitoring were used.Pre- and postoperative hearing measures and facial function, tumor size, and postoperative complications. Hearing status was categorized into Classes A, B, C, and D as described by the American Academy of Otolaryngology-Head and Heck Surgery "Guidelines for the Evaluation of Hearing Preservation in Acoustic Neuroma, 1995."Thirty-four patients presented with Class

2006 Otology and Neurotology

9930. Cranial nerve involvement in nasopharyngeal carcinoma: response to radiotherapy and its clinical impact. (PubMed)

Cranial nerve involvement in nasopharyngeal carcinoma: response to radiotherapy and its clinical impact. To evaluate the cranial nerve (CN) palsy associated with nasopharyngeal carcinoma (NPC), we studied factors that influenced the neurologic outcome of radiotherapy (RT), and the patterns and time course of neurologic recovery of CN palsy.Between July 1987 and July 1989, 93 patients who presented with CN palsy at the time of diagnosis of NPC were studied. All patients underwent external-beam (...) commonly involved CN V (38%), CN VI (26%), and CN XII (11%), which accounted for the majority of the cases (75%). The time course of CN recovery was variable and protracted. Most patients showed significant improvement upon completion of RT (51%, 19%, and 30% complete, partial, and no recovery, respectively) and further improvement 6 months after RT (58%, 17%, and 25%, respectively). Cranial nerves V, VI, and XII accounted for 75% of cases with no recovery. Recovery was best for CNs II, IX, and XI

2006 Rhinology and Laryngology

9931. Disseminated histoplasmosis presenting as a unilateral cranial nerve VIII mass: a case report. (PubMed)

Disseminated histoplasmosis presenting as a unilateral cranial nerve VIII mass: a case report. To report a unique presentation of disseminated histoplasmosis.Case report.University hospital, tertiary referral center.Our patient presented with vertigo, tinnitus, and unilateral hearing loss, and was initially found to have a 5-mm enhancing left internal auditory canal mass, as revealed by a magnetic resonance imaging (MRI) scan. Subsequently, the patient developed multiple focal neurologic (...) deficits.Magnetic resonance imaging and treatment with intravenously administered amphotericin B, with subsequent oral administration of itraconazole.Clinical presentation and imaging findings of Histoplasmosis involving the cranial nerve VIII.A subsequent MRI scan revealed enlargement of the initial lesion and multiple parenchymal lesions. Further workup revealed a pulmonary lesion; the diagnosis of disseminated histoplasmosis was made on the basis of bronchoalveolar lavage culture.Infectious processes

2006 Otology and Neurotology

9932. Intracranial schwannomas of the lower cranial nerves. (PubMed)

Intracranial schwannomas of the lower cranial nerves. To present our experience in the diagnosis and management of 39 patients with lower cranial nerve schwannomas of the posterior fossa.A retrospective chart review of patient medical records.Tertiary care, academic medical center.All patients with intracranial lower cranial nerve schwannomas treated surgically in our institution between July 1998 and July 2005.A retrosigmoid, transcondylar, or combined approach was used for tumor (...) recurrence.Thirty-nine patients underwent surgical resection, with complete tumor removal in 32, near-total resection in 5 patients, and subtotal tumor excision in 2 patients. Long-term (mean, 8.2 years) magnetic resonance imaging surveillance demonstrated recurrent tumor in 2 of 32 complete resections and slow regrowth in 2 of 7 patients with known residual disease. Only one of these four patients required reoperation.Intracranial schwannomas of the lower cranial nerves are relatively uncommon and may present

2006 Otology and Neurotology

9933. Cranial nerve involvement in malignant external otitis: implications for clinical outcome. (PubMed)

on inclusion criteria of severe pain, otitis externa refractory to conventional treatments, diabetes mellitus, and Pseudomonas aeruginosa detection. Computed tomography confirmed temporal bone involvement extending outside the external auditory canal.Retrospective analysis of hospital records.Ten of 23 (43.5%) patients showed cranial nerve involvement. The following cranial nerves were affected: facial nerve (6/10), lower cranial nerves (combination of IX, X, XI, XII) (3/10), and extended nerve palsy (VI (...) , VII, IX, X, XI) (1/10). Thirteen of 23 (56.5%) patients displayed no cranial nerve involvement. All patients were treated with long-term, high-dose antibiotic treatment dependent on the microbiological findings.All patients with lower cranial nerve palsy recovered normal function; however, the facial nerve palsy was significantly less likely to improve by medical treatment. Cranial nerve involvement did not affect the patient survival rate under an optimized medical treatment in our series.

2007 Laryngoscope

9934. Lemierre's syndrome presenting with peritonsillar abscess and VIth cranial nerve palsy. (PubMed)

Lemierre's syndrome presenting with peritonsillar abscess and VIth cranial nerve palsy. Lemierre's syndrome is characterized by acute oropharyngeal infection complicated by internal jugular venous thrombosis secondary to septic thrombophlebitis, and metastatic abscesses. We report a case of Lemierre's syndrome in an 18-year-old Caucasian woman presenting with a peritonsillar abscess and ipsilateral VIth cranial nerve palsy.

2006 Journal of Laryngology & Otology

9935. Fascicle preservation surgery for facial nerve neuromas involving the posterior cranial fossa. (PubMed)

Fascicle preservation surgery for facial nerve neuromas involving the posterior cranial fossa. To assess facial nerve function after fascicle preservation surgery in cases of facial nerve neuroma involving the cerebellopontine angle.Retrospective case series and literature review.Tertiary referral center.Seven patients with facial nerve neuroma involving the posterior cranial fossa were reviewed from a single neurotologist's practice and combined with a review of 648 cases reported (...) in the literature.Translabyrinthine resection was used in all patients for complete tumor removal. Nerve reconstruction was accomplished with fascicle preservation (three cases), cable nerve interposition grafting (three cases, one of which involved using cranial nerve VIII as the graft), or direct anastomosis (one case).Facial nerve function as measured by the House-Brackmann grading system. RESULTS A postoperative facial nerve (House-Brackmann) grade of II/VI was obtained in two of our three patients who underwent fascicle

2003 Otology and Neurotology

9936. Fracture of skull base with delayed multiple cranial nerve palsies. (PubMed)

Fracture of skull base with delayed multiple cranial nerve palsies. This report describes a pediatric case of delayed glossopharyngeal nerve, vagus nerve, and facial nerve palsies after a head injury. Computed tomography scan of the skull base revealed the fracture of the petrous part of the temporal bone, and the fracture involved the tip of petrous pyramid, in front of the jugular foramen. The anatomical features, mechanisms, diagnosis, and treatment are discussed.

2005 Pediatric Emergency Care

9937. Fourth and sixth cranial nerve injury after halo traction in children: a report of two cases. (PubMed)

Fourth and sixth cranial nerve injury after halo traction in children: a report of two cases. Spinal traction is the application of a longitudinal force to the spinal column as a means of stabilizing a damaged or abnormal spine. Although not well documented in the ophthalmic literature, complications include cranial nerve palsies, with the sixth nerve being most commonly affected. Fourth nerve palsies have not previously been reported to our knowledge. We present 2 cases of combined fourth (...) partial resolution of the cranial nerve injuries.Cranial nerve injury may occur with spinal traction. Fourth nerve palsy may be underreported because of masking by a coinciding sixth nerve palsy.

2004 JAAPOS - Journal of the American Association for Pediatric Ophthalmology and Strabismus

9938. Maternal diabetes in the rat impairs the formation of neural-crest derived cranial nerve ganglia in the offspring. (PubMed)

staining of embryos from normal and diabetic mothers to investigate the development of cranial nerve ganglia. Neural tube explants were cultured in 10 and 40 mmol/l glucose and cell death and caspase activity was measured with flow cytometry.The development of cranial ganglia V, VII, VIII, IX and X was impaired in day 10-11 embryos of diabetic rats. There was also a higher rate of cell death of neural crest derived cells cultured in 40 mmol/l glucose for 20 h (35% compared to 12% in 10 mmol/l). However (...) Maternal diabetes in the rat impairs the formation of neural-crest derived cranial nerve ganglia in the offspring. Maternal diabetes mellitus increases the risk for fetal malformations. Several of these malformations are found in organs and tissues derived from the neural crest. Previous studies have shown changes in fetal organs of neural crest origin in experimental diabetes and changes in migration of neural crest cells exposed to high glucose in vitro.We used whole-mount neurofilament

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2003 Diabetologia

9939. Nasopharyngeal carcinoma with cranial nerve palsy: the importance of MRI for radiotherapy. (PubMed)

Nasopharyngeal carcinoma with cranial nerve palsy: the importance of MRI for radiotherapy. To evaluate various prognostic factors and the impact of imaging modalities on tumor control in patients with nasopharyngeal cancer (NPC) with cranial nerve (CN) palsy.Between September 1979 and December 2000, 330 NPC patients with CN palsy received radical radiotherapy (RT) by the conventional opposing technique at Chang Gung Memorial Hospital-Linkou. Imaging methods used varied over that period (...) to 156 patients in addition to external RT, delivered by the remote after-loading, high-dose-rate technique. A total of 139 patients received cisplatin-based chemotherapy, in 115 received as neoadjuvant or adjuvant chemotherapy and in 24 concomitant with RT. Recovery from CN palsy occurred in 171 patients during or after radiotherapy. Patients who died without a specific cause identified were regarded as having died with persistent disease.The 3-year, 5-year, and 10-year overall survival was 47.1

2005 Biology and Physics

9940. Cranial nerve deficits in patients with metastatic prostate carcinoma: clinical features and treatment outcomes. (PubMed)

Cranial nerve deficits in patients with metastatic prostate carcinoma: clinical features and treatment outcomes. Cranial nerve lesions due to metastases from prostate carcinoma to the skull base are an uncommon yet clinically significant finding.The authors report the clinical features, treatment, and outcomes for 15 patients who presented with cranial nerve palsies complicating metastatic prostate carcinoma. Patient charts identified from a Fox Chase Cancer Center treatment data base were (...) reviewed.All patients had hormone-refractory disease at the time of symptom onset. Twelve of 15 patients had received prior chemotherapy, and 13 of 15 patients had received prior radiation therapy to areas of bony pain. Symptoms varied from recognized clinical syndromes involving multiple cranial nerves to isolated cranial nerve lesions. All patients had lesions at the skull base that were visualized on computed tomography scans or magnetic resonance images. All patients were treated with palliative

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2004 Cancer

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