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How good at neurology are you? — QUESTIONS

1. Two patients seen in the same week—what is the syndrome that links them?

Patient 1. A 26 year old previously well English nurse coping with her new role in New Zealand, developed mild right frontal and retro-ocular discomfort, vague forehead paraesthesiae, and also ipsilateral drooping of her eyelid and a small pupil during a morning shift at work. No history of neck injury. Examination showed a partial right Horner’s syndrome, preserved facial sweating and a mild reduction in sensation in the ophthalmic division of the fifth cranial nerve, including reduced corneal sensation. Normal MR brain and MR angiography.

Patient 2. A 67 year old man presented with left sided facial pain and numbness, and diplopia for one month. Examination showed a Horner’s syndrome, fourth nerve palsy, and an incomplete trigeminal neuropathy (V1 and V2 only). A swelling, about 5 mm diameter, was palpable on the mid cheek. . . . [Full text of this article]

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Answers
Practical Neurology 2007 7: 204-205. [Extract] [Full Text] [PDF]