Document Detail

Occipital condyle syndrome as the first sign of metastatic cancer.
MedLine Citation:
PMID:  18062455     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Occipital condyle syndrome is characterized by severe, unilateral, occipital headache and ipsilateral twelfth-nerve palsy. It is associated with skull-base metastasis. CASES: We identified two patients with sub-acute onset of severe, unilateral, occipital headache and ipsilateral tongue paralysis. The first patient was a 58-year-old woman with a history of limited stage small-cell lung cancer in clinical remission. The second patient was an otherwise healthy 36-year-old man. Neither patient had any other findings on general medical or neurological examination. One patient had only equivocal findings on initial magnetic resonance imaging (MRI), and the other patient's MRI was normal. Although initial work-up for metastatic disease was normal, the first patient developed severe bone pain over the next few months, and follow-up investigations demonstrated metastases to her spine, tibia, skull base and brain. The second patient improved initially, but was admitted to hospital three months later with constitutional symptoms and pancytopenia. Bone marrow and lymph node biopsies were consistent with Stage IVB Hodgkin's lymphoma. CONCLUSION: Occipital condyle syndrome can be the first presentation of disseminated malignancy. Initial imaging of the brain and skull base may be normal, and recognition of this syndrome warrants thorough investigation and close follow-up.
Jeremy J Moeller; Sudeep Shivakumar; Mary Davis; Charles E Maxner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques     Volume:  34     ISSN:  0317-1671     ISO Abbreviation:  Can J Neurol Sci     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-12-07     Completed Date:  2008-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0415227     Medline TA:  Can J Neurol Sci     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  456-9     Citation Subset:  IM    
Division of Neurology, Department of Medicine, Dalhousie University, Capital District Health Authority, Halifax, Nova Scotia, Canada.
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MeSH Terms
Carcinoma, Small Cell / secondary
Headache / etiology*
Hodgkin Disease / pathology
Hypoglossal Nerve Diseases / etiology,  physiopathology
Lung Neoplasms / pathology
Middle Aged
Occipital Bone / pathology
Paresis / etiology
Skull Neoplasms / complications*,  physiopathology*,  secondary*
Tongue Diseases / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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