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Hemiplegic peripheral neuropathy accompanied with multiple cranial nerve palsy
- Source :
- Clinics and Practice, Vol 2, Iss 2 (2012), Clinics and Practice, Clinics and Practice; Volume 2; Issue 2; Pages: e40
- Publication Year :
- 2012
- Publisher :
- MDPI AG, 2012.
-
Abstract
- A 32-year-old man experienced double vision around January, 2010, followed by weakness of his left upper and lower extremities. Articulation disorders and loss of hearing in his left ear developed, and he was admitted to our hospital on February 14, 2010. Physical examination was normal, and neurological examination showed clear consciousness with no impairment of cognitive function, but with articulation disorders. Olfactory sensation was reduced. Left ptosis and left gaze palsy, complete left facial palsy, perceptive deafness of the left ear, and muscle weakness of the left trapezius muscle were observed. Paresis in the left upper and lower extremities was graded 4/5 through manual muscle testing. Sensory system evaluation revealed complete left-side palsy, including the face. Deep tendon reflexes were slightly diminished equally on both sides; no pathologic reflex was seen. No abnormality of the brain parenchyma, cerebral nerves or cervicothoracolumbar region was found on brain magnetic resonance imaging. On electroencephalogram, alpha waves in the main frequency band of 8 to 9 Hz were recorded, indicating normal findings. Brain single photon emission computed tomography (SPECT) scan showed reduced blood flow in the right inner frontal lobe and both occipital lobes. Nerve biopsy (left sural nerve) showed reduction of nerve density by 30%, with demyelination. The patient also showed manifestations of multiple cranial nerve disorder, i.e., of the trigeminal nerve, glossopharyngeal nerve, vagus nerve, and hypoglossal nerve. Whole-body examination was negative. Finally, based on ischemic brain SPECT images, spinal fluid findings and nerve biopsy results, peripheral neuropathy accompanied with multiple cranial nerve palsy was diagnosed.
- Subjects :
- medicine.medical_specialty
Cranial Nerve Disorder
Article
hemiplegic peripheral neuropathy
multiple cranial nerve palsy
brain SPECT
nerve biopsy
demyelination
high-dose intravenous gamma-globulin
medicine
Trigeminal nerve
lcsh:R5-920
Nerve biopsy
medicine.diagnostic_test
business.industry
General Medicine
Anatomy
medicine.disease
Surgery
Vagus nerve
medicine.anatomical_structure
Peripheral neuropathy
Peripheral nervous system
Glossopharyngeal nerve
business
lcsh:Medicine (General)
Hypoglossal nerve
Subjects
Details
- Language :
- English
- ISSN :
- 20397283 and 20397275
- Volume :
- 2
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Clinics and Practice
- Accession number :
- edsair.doi.dedup.....d2cdf2971fb75efdd8adc8a4fa2d9731