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Cranial Nerve 10

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9941. Isolated cranial nerve III palsy as the presenting manifestation of HIV-related large B-cell lymphoma: clinical, radiological and postmortem observations: report of a case and review of the literature. (Abstract)

were positive. Postmortem examination of the brain revealed malignant lymphomatous cell infiltration of both cranial nerve III, diffuse leptomeningeal disease and focal superficial subependymal and subpial invasion. Based on our review of the literature, we were able to find only 10 detailed cases of cranial nerve III palsy as the presenting manifestation of central nervous system lymphoma. Furthermore, none of the previously reported cases correlated the magnetic resonance imaging findings (...) Isolated cranial nerve III palsy as the presenting manifestation of HIV-related large B-cell lymphoma: clinical, radiological and postmortem observations: report of a case and review of the literature. Rarely can a neurologically isolated cranial nerve III palsy be the presenting manifestation of central nervous system lymphoma. We detail the clinical, radiological, and pathological features of a previously healthy 45-year-old man presenting with an isolated, pupil-involving, right cranial

2005 Survey of Ophthalmology

9942. Giant cell arteritis with multiple cranial nerve palsy and reversible proptosis: a case report. (Abstract)

Giant cell arteritis with multiple cranial nerve palsy and reversible proptosis: a case report. Giant cell arteritis (GCA) often presents with symptoms of headache, jaw claudication, polymyalgia rheumatica, and blurred vision. GCA is relatively rare and may have atypical manifestations in Asians, including multiple cranial nerve palsy and reversible proptosis. A high suspicion of GCA is suggested when any older Asian suffers from headache that is new-onset or different from the previous pattern

2007 Headache

9943. Multiple cranial nerve palsies following radiofrequency ablation for trigeminal neuralgia. (Abstract)

Multiple cranial nerve palsies following radiofrequency ablation for trigeminal neuralgia. A 33-year-old man developed diffuse subarachnoid haemorrhage following attempted radiofrequency ablation for trigeminal neuralgia. Over the next 2 weeks, he progressively developed multiple bilateral cranial nerve palsies, bilateral cerebellar signs, hypotonia of all four limbs and diminished vision in both eyes. A visual-evoked potential study revealed anterior visual pathway defect. A possibility

2008 British Journal of Neurosurgery

9944. Hearing preservation and facial nerve outcomes in vestibular schwannoma surgery: results using the middle cranial fossa approach. (Abstract)

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

9945. Cranial nerve involvement in nasopharyngeal carcinoma: response to radiotherapy and its clinical impact. (Abstract)

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

9946. Isolated inflammatory sphenoiditis with multiple unilateral cranial nerve palsies. (Abstract)

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

9947. Lemierre's syndrome presenting with peritonsillar abscess and VIth cranial nerve palsy. (Abstract)

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

9948. Disseminated histoplasmosis presenting as a unilateral cranial nerve VIII mass: a case report. (Abstract)

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

9949. Intracranial schwannomas of the lower cranial nerves. (Abstract)

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

9950. Anti-GQ1b-negative Miller-Fisher syndrome with lower cranial nerve involvement from parasinusoidal aspergilloma. (Abstract)

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

9951. Cranial nerve involvement in malignant external otitis: implications for clinical outcome. (Abstract)

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

9952. Fracture of skull base with delayed multiple cranial nerve palsies. (Abstract)

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

9953. Bilateral involvement of a single cranial nerve: analysis of 578 cases. (Abstract)

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

9954. Superior divisional third cranial nerve paresis: clinical and anatomical observations of 2 unique cases. Full Text available with Trip Pro

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

2006 Archives of Neurology

9955. Multiple cranial nerve palsies: analysis of 979 cases. Full Text available with Trip Pro

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

2005 Archives of Neurology

9956. Postinfectious myeloradiculoneuropathy with cranial nerve involvements associated with human herpesvirus 7 infection. Full Text available with Trip Pro

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

2005 Archives of Neurology

9957. Motor responses of muscles supplied by cranial nerves to subthalamic nucleus deep brain stimuli. Full Text available with Trip Pro

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

2007 Brain

9958. Cranial nerve deficits in patients with metastatic prostate carcinoma: clinical features and treatment outcomes. Full Text available with Trip Pro

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

2004 Cancer

9959. Nasopharyngeal carcinoma with cranial nerve palsy: the importance of MRI for radiotherapy. (Abstract)

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

9960. Pituitary apoplexy presenting as unilateral third cranial nerve palsy after coronary artery bypass surgery. (Abstract)

Pituitary apoplexy presenting as unilateral third cranial nerve palsy after coronary artery bypass surgery. The new onset of pituitary apoplexy is a rare perioperative complication of coronary artery bypass surgery. A variety of clinical presentations of pituitary apoplexy have been reported including absence of clinical symptoms or headache, sudden deterioration of mental status, visual changes, Addisonian crisis, and ophthalmoplegia, including third cranial nerve palsy and/or ptosis. Early

2004 Anesthesia and Analgesia

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