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Three-dimensional-fast imaging employing steady-state acquisition and T2-weighted fast spin-echo magnetic resonance sequences on visualization of cranial nerves Ⅲ-Ⅻ

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Chinese Medical Journal 2008年第3期121卷 276-279页

作者： CHENG Yu-shu ZHOU Zheng-rong PENG Wei-jun TANG Feng Department of Diagnostic Radiology Cancer Hospital FudanUniversity Shanghai 200032 China

Because of the small diameter and complex anatomic course of the cranial nerves except for the optic nerve, trigeminal nerve, facial nerve, and cochlear and vestibular nerve, other cranial nerves are difficult to be visualized in magnetic resonance imaging （MRI） scanning with conventional thickness （5-10 mm）. With the rapid development of MRI technology high spatial resolution, three-dimensional and two-dimensional magnetic resonance imaging technologies have been used in recent years in the observation of normal and abnormal cranial nerves, including three-dimensional constructive interference in steady state （3D CISS） sequence, three- dimensional magnetization-prepared rapid gradient-echo （3D MP-RAGE） sequence, three-dimensional fast inflow with steady-state precession （3D FISP） seohuence, and some fast spin-echo （FSE） sequences. - Threedimensional fast imaging employing steady-state acquisition （3D-FIESTA） is a fast three-dimensional steady-state imaging sequence with high spatial resolution and contrast between the organizational structures. And this sequence was reportedly used in the study on the diseases in the cerebellopontine angle; inner ear and posterior fossa tumors.7＇8 However, the reports about the value of 3D-FIESTA sequence for the visualization of normal cranial nerves are still rare.

关键词： cranial nerves magnetic resonance imaging pulse sequence

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Differences in individual susceptibility affect the development of trigeminal neuralgia

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Neural Regeneration Research 2013年第14期8卷 1337-1342页

作者： Yusuf Kurtulus Duransoy Mesut Mete Emrah Akay Mehmet Seluki Department of Neurosurgery Celal Bayar University School of Medicine Clinic of Neurosurgery Anamur State Hospital

Trigeminal neuralgia is a syndrome due to dysfunctional hyperactivity of the trigeminal nerve, and is characterized by a sudden, usually unilateral, recurrent lancinating pain arising from one or more divisions of the nerve. The most accepted pathogenetic mechanism for trigeminal neuralgia is compression of the nerve at its dorsal root entry zone or in its distal course. In this paper, we report four cases with trigeminal neuralgia due to an unknown mechanism after an intracranial intervention The onset of trigeminal neuralgia after surgical interventions that are unrelated to the trigeminal nerve suggests that in patients with greater individual susceptibility, nerve contact with the vascular structure due to postoperative pressure and changes in cerebrospinal fluid flow may cause the onset of pain.

关键词： neural regeneration peripheral nerve injury asymptomatic vascular compression of the cranialnerves cranial nerves dorsal root entry zone dorsal root exit zone etiology hyperactivedysfunction syndrome individual susceptibility risk factors trigeminal neuralgia neuroregeneration

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Neck pain and absence of cranial nerve symptom are clues of cervical myelopathy mimicking stroke:Two case reports

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World Journal of Clinical Cases 2022年第32期10卷 11835-11844页

作者： Li-Li Zhou Shi-Guo Zhu Yuan Fang Shi-Shi Huang Jie-Fan Huang Ze-Di Hu Jin-Yu Chen Xiong Zhang Jian-Yong Wang Institute of Geriatric Neurology Department of NeurologyThe Second Affiliated Hospital and Yuying Children’s HospitalWenzhou Medical UniversityWenzhou 325027Zhejiang ProvinceChina

BACKGROUND Cervical myelopathy is a potential stroke imitator,for which intravenous thrombolysis would be *** SUMMARY We herein present two cases of cervical *** first patient presented with acute onset of right hemiparesis and urinary incontinence,and the second patient presented with sudden-onset right leg *** initial diagnoses for both of them were ischemic ***,both of them lacked cranial nerve symptom and suffered neck pain at the beginning of *** cervical spinal cord lesions were finally confirmed by cervical computed tomography.A literature review showed that neck pain and absence of cranial nerve symptom are clues of cervical *** The current report and the review remind us to pay more attention to these two clues in suspected stroke patients,especially those within the thrombolytic time window.

关键词： Cervical cord Spinal cord diseases Stroke Neck pain cranial nerves Hematoma,epidural,spinal Neoplasm metastasis Case report

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Intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation for preservation of facial nerve function in patients with large acoustic neuroma

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Chinese Medical Journal 2007年第4期120卷 323-325页

作者： LIU Bai-yun TIAN Yong-ji LIU Wen LIU Shu-ling QIAO Hui ZHANG Jun-ting Jim Gui-jun Department of Neurosurgery Beijing Tiantan Hospital CapitalMedical University Beijing 100050 China Beijing Neurosurgical Institute Beijing 100050 China

Background Although various monitoring techniques have been used routinely in the treatment of the lesions in the skull base, iatrogenic facial paresis or paralysis remains a significant clinical problem. The aim of this study was to investigate the effect of intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation on preservation of facial nerve function. Method From January to November 2005, 19 patients with large acoustic neuroma were treated using intraoperative facial motor evoked potentials monitoring with transcranial electrical stimulation （TCEMEP） for preservation of facial nerve function. The relationship between the decrease of MEP amplitude after tumor removal and the postoperative function of the facial nerve was analyzed. Results MEP amplitude decreased more than 75% in 11 patients, of which 6 presented significant facial paralysis （H-B grade 3）, and 5 had mild facial paralysis （H-B grade 2）. In the other 8 patients, whose MEP amplitude decreased less than 75%, 1 experienced significant facial paralysis, 5 had mild facial paralysis, and 2 were normal. Conclusions Intraoperative TCEMEP can be used to predict postoperative function of the facial nerve. The decreased MEP amplitude above 75 % is an alarm point for possible severe facial paralysis.

关键词： acoustic neuroma motor evoked potentials cranial nerves

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Multiple cranial Nerve Palsies in Otolaryngology Consultation: An Atypical Clinical Presentation Revealing Myasthenia Gravis

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第6期11卷 306-316页

作者： Adèle-Rose Ngo Nyeki Paul Cedric Mbonda Léonel Atanga Yannick Mossus Roger Meva’a Victor Sini Mambo Olive Ngaba David Mindja Francois Djomou Callixte Kuate Richard Njock Alexis Ndjolo Department of Ophthalmology-ENT-Stomatology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Central Hospital of Yaoundé Yaoundé Cameroon Department of Neurology General Hospital of Yaoundé Yaoundé Cameroon Department of Neurology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Introduction: Myasthenia gravis is a chronic autoimmune neuromuscular disease, presents with weakness and fatigability of striated skeletal muscles. It is a rare disease in Cameroon. We report an uncommon case of myasthenia gravis in a patient with feeding difficulties, notion of oronasal reflux and swallowing disorders as first complaints. Observation: We report the case of a 29-year-old woman consulted at our department of Otolaryngology and Cervico-Facial Surgery for dysphagia and swallowing disorders. She also presented with facial diplegia, oculomotor paralysis, nasal voice, and dysarthria which has been evolving for several years now. The clinical examination revealed multiple cranial nerve palsies. The complementary workup showed a decrement of more than 50% in the electroneuromyography and the presence of anti-acetylcholine receptor autoantibodies in the blood workup. A diagnosis of myasthenia confirms clinical presumption. We initially observed a worsening of neuromuscular disorders despite the pyridostigmine treatment and subsequently a clear improvement of the clinical features concerning swallowing and speech disorders, oculomotricity and facial diplegia under a treatment combining prednisone and azathioprine. Conclusion: Myasthenia gravis is a rare and potentially fatal autoimmune neuromuscular disease. We thus highlight the atypical clinical presentation and therapeutic itinerary of our patient and the importance to think about this clinical diagnosis in front of any multiple cranial nerve paralysis in otolaryngology consultation.

关键词： Clinical Case Dysphagia Swallowing Disorders Facial Diplegia Nasal Voice Myasthenia Autoimmune Paralysis cranial nerves

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Skull Base Osteomyelitis: A Rare Cause of Multiple cranial Nerve Palsies—A Case Report from Ghana

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World Journal of Neuroscience 2023年第4期13卷 257-265页

作者： Ekins Kuuzie Prince Kwabla Pekyi-Boateng Annie Yennah Fiifi Duodu Department of Surgery St. Dominic Hospital Akwatia Ghana Department of Anesthesiology 37 Military Hospital Accra Ghana Department of Surgery Ho Teaching Hospital Ho Ghana Department of Neurology Korle-Bu Teaching Hospital Accra Ghana

Introduction: Skull Base Osteomyelitis (SBO) is an infectious inflammation of the skull bones that is often caused by malignant otitis externa (MOE) and affects the temporal bone. This condition commonly affects immunocompromised individuals and the elderly, particularly those with a history of diabetes mellitus. Diagnosis is challenging because of non-specific symptoms that lead to late detection and complications. This report discusses a case of SBO with multiple bilateral cranial nerve abnormalities and highlights the diagnostic and management challenges in high-risk individuals with subtle clinical signs. Case presentation: This report describes a 63-year-old patient with hypertension and diabetes who underwent surgical debridement of the left ear due to malignant otitis externa 4 months prior to presentation. The patient presented with significant dysarthria, dysphagia, ptosis of the left eye with double vision, and hearing impairment in the left ear. Examination revealed bilateral CN VI palsy, right CN VII palsy, left CN VIII palsy, and a right CN XII deficit. Initial tests were unremarkable, but a high Fungitell assay and a second review of the CT scan and MRI revealed a pathological process in the base of the skull involving bony structures and cranial nerves bilaterally, which helped diagnose SBO. The patient was subsequently discharged with oral voriconazole and continued his usual medications. The patient requested further management abroad, because he did not notice resolution of his symptoms. Surgical treatment was employed abroad to relieve his symptoms, as he recovered slowly. Conclusion: This case report underscores the importance of a multidisciplinary approach to address SBO. Collaboration between specialists in infectious diseases, otolaryngology, radiology, and neurology plays a pivotal role in achieving an accurate diagnosis and developing a tailored treatment plan. Although SBO may be infrequent, this case report highlights the need to maintain

关键词： Skull Base Osteomyelitis cranial nerves Malignant Otitis Externa Bulbar Palsy Fungal Infection

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