Multiple cranial nerve palsies have many possible causes, including infective, inflammatory, neoplastic and infiltrative diseases of the meninges or skull base. We present the clinicopathological conference of a 27-year-old man with a smouldering course of sequential cranial nerve palsies. His imaging showed dural thickening and osteosclerosis of the skull base with otomastoiditis. Cerebrospinal fluid showed lymphocytic pleocytosis with reduced glucose and normal protein concentrations. There was a possible response to corticosteroids and anti-tubercular treatment. Initial biopsy from the thickened and enhancing dura was unremarkable. His condition deteriorated after the steroids were tapered; MR imaging showed progression of lesions and positron emission tomography showed intense hypermetabolism. Subsequently, a diagnostic test revealed the final diagnosis. This case was presented at the All India Institute of Medical Sciences’ monthly clinicopathological conference series in February 2021.
- clinical neurology
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Read the full text or download the PDF:
Other content recommended for you
- A diagnostic dilemma of central skull base osteomyelitis mimicking neoplasia in a diabetic patient
- Successful surgical optic nerve decompression in a patient with hypertrophic pachymeningitis due to granulomatous polyangiitis
- Expression of LEF1 and TCF1 (TCF7) proteins associates with clinical progression of nasopharyngeal carcinoma
- Epstein-Barr virus infection in the pathogenesis of nasopharyngeal carcinoma
- Nasopharynx carcinoma: a rare primary for bilateral breast metastasis
- Not a microvascular sixth nerve palsy
- Associations of Rsf-1 overexpression with poor therapeutic response and worse survival in patients with nasopharyngeal carcinoma
- Skull base imaging, anatomy, pathology and protocols
- Eye twist and tongue twist: a rare neurological syndrome
- A case of idiopathic hypertrophic cranial pachymeningitis presenting high values of matrix metalloproteinase