Document Detail

A case of bilateral lower cranial nerve palsies after base of skull trauma with complex management issues: case report and review of the literature.
MedLine Citation:
PMID:  22549358     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Fractures of the skull base can cause lower cranial nerve palsies because of involvement of the nerves as they traverse the skull. A variety of syndromes have been described, often involving multiple nerves. These are most commonly unilateral, and only a handful of cases of bilateral cranial nerve involvement have been reported.
CASE REPORT: We describe a 64-year-old man with occipital condylar fracture complicated by bilateral palsies of IX and X nerves associated with dramatic physiological derangement causing severe management challenges. Apart from debilitating postural hypotension, he developed dysphagia, severe gastrointestinal dysmotility, issues with airway protection as well as airway obstruction, increased oropharyngeal secretions and variable respiratory control.
CONCLUSIONS: This is the first report of a patient with traumatic bilateral cranial nerve IX and X nerve palsies. This detailed report and the summary of all 6 previous case reports of traumatic bilateral lower cranial nerve palsies illustrate clinical features, treatment strategies, and outcomes of these rare events.
Alexander Christoph Lehn; Jennie Lettieri; Rohan Grimley
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  The neurologist     Volume:  18     ISSN:  2331-2637     ISO Abbreviation:  Neurologist     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-02     Completed Date:  2012-09-05     Revised Date:  2014-11-05    
Medline Journal Info:
Nlm Unique ID:  9503763     Medline TA:  Neurologist     Country:  United States    
Other Details:
Languages:  eng     Pagination:  152-4     Citation Subset:  IM    
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MeSH Terms
Alkalosis, Respiratory / etiology
Cranial Nerve Diseases* / diagnosis,  etiology,  therapy
Deglutition Disorders / etiology
Gastrointestinal Diseases / etiology
Hypotension, Orthostatic / etiology
Middle Aged
Occipital Bone / pathology
Skull Fractures / complications*
Tomography, X-Ray Computed

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

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