A case of bilateral lower cranial nerve palsies after base of skull trauma With complex management issues case report and review of the literature

Lehn, Alexander Christoph, Lettieri, Jennie and Grimley, Rohan (2012) A case of bilateral lower cranial nerve palsies after base of skull trauma With complex management issues case report and review of the literature. Neurologist, 18 3: 152-154.


Author Lehn, Alexander Christoph
Lettieri, Jennie
Grimley, Rohan
Title A case of bilateral lower cranial nerve palsies after base of skull trauma With complex management issues case report and review of the literature
Journal name Neurologist   Check publisher's open access policy
ISSN 1074-7931
Publication date 2012-05
Sub-type Article (original research)
DOI 10.1097/NRL.0b013e318247bb6f
Volume 18
Issue 3
Start page 152
End page 154
Total pages 3
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Collection year 2013
Language eng
Formatted abstract 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.
Keyword Occipital bone
Skull fractures
Glossopharyngeal nerve
Vagus nerve
Jugular foramen
Occipital Condyle
Fractures
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
 
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