1/28. Possible role of an endovascular provocative test in the diagnosis of glossopharyngeal neuralgia as a vascular compression syndrome.We utilized endovascular provocative techniques to identify the indications for microvascular decompression surgery in a serious case of glossopharyngeal neuralgia. This is the first reported case in which an endovascular provocative test was applied for diagnosis of glossopharyngeal neuralgia as a vascular compression syndrome. A 68-year-old woman presented with severe paroxysmal facial pain which could not be controlled by medical therapy. Partial effectiveness to carbamazepine led us to wonder whether or not the selection of microvascular decompression surgery would be appropriate. Pre-operative angiography was performed. During the examination a microcatheter was inserted into the right posterior inferior cerebellar artery (pica), and an attack of typical glossopharyngeal neuralgia occurred. The patient thus underwent microvascular decompression surgery. The pica was verified to compress the glossopharyngeal nerve and therefore was moved to induce decompression. The patient has since experienced no further pain for one year postoperatively. The diagnosis of glossopharyngeal neuralgia is sometimes complex and it is difficult to select the most appropriate surgical modality. In such cases this endovascular provocative technique may thus be useful for making a definitive decision or microvascular decompression surgery.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/28. Jefferson fracture resulting in Collet-Sicard syndrome.STUDY DESIGN: A case report and review of the literature. OBJECTIVE: To increase awareness of and add to the spectrum of injury that can result from Jefferson fractures, to suggest a possible mechanism of injury, and to give a brief review of pertinent facts regarding C1 burst fractures and the Collet-Sicard Syndrome. SUMMARY OF BACKGROUND DATA: To the author's knowledge, this is the first reported case of a Jefferson fracture resulting in Collet-Sicard Syndrome. It represents only the second reported case of cranial nerve palsy caused by Jefferson fracture. methods: A 56-year-old man sustained a C1 burst fracture in a rollover motor vehicle accident. Repeated neurologic examinations over the ensuing days revealed lesions of cranial nerves IX, X, XI, and XII on the left side. RESULTS: Two weeks of traction, 10 weeks in a halo vest, and 2 weeks in a cervical collar resulted in adequate fracture healing and almost complete resolution of the patient's neurologic symptoms. CONCLUSION: Although this is the first reported case of Collet-Sicard Syndrome caused by Jefferson fracture, the authors' review of the literature suggests that cranial nerve injuries may go unrecognized in some patients with C1 burst fractures. The importance of a thorough neurologic examination, including examination of the cranial nerves, in all cases of cervical spine injury cannot be overemphasized.- - - - - - - - - - ranking = 7.9887549323953keywords = nerve, cranial nerve, palsy (Clic here for more details about this article) |
3/28. Neurovascular compression of the trigeminal and glossopharyngeal nerve: three case reports.trigeminal neuralgia (TN) is a frequent cause of paroxysmal facial pain and headache in adults. Glossopharyngeal neuralgia (GPN) is less common, but can cause severe episodic pain in the ear and throat. Neurovascular compression of the appropriate cranial nerve as it leaves the brain stem is responsible for the symptoms in many patients, and neurosurgical decompression of the nerve is now a well accepted treatment in adults with both TN and GPN who fail to respond to drug therapy. Neither TN nor GPN are routinely considered in the differential diagnosis when assessing children with paroxysmal facial or head pain, as they are not reported to occur in childhood. case reports of three children with documented neurovascular compression causing severe neuralgic pain and disability are presented. The fact that these conditions do occur in the paediatric population, albeit rarely, is highlighted, and appropriate investigation and management are discussed.- - - - - - - - - - ranking = 6.9954864303139keywords = nerve, cranial nerve (Clic here for more details about this article) |
4/28. Glossopharyngeal neuralgia following foreign body impaction in the neck.Glossopharyngeal neuralgia is rare, typically idiopathic and treated with carbamazepine. Surgery to decompress or transect the glossopharyngeal nerve root may be performed if conservative management fails. We present a case following trauma to the neck with foreign body impaction. To our knowledge this is the first case of glossopharyngeal neuralgia due to neck trauma.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
5/28. Tonsillar pain mimicking glossopharyngeal neuralgia as a complication of vagus nerve stimulation: case report.An adolescent girl presented with severe, lancinating tonsillar pain exacerbated by swallowing 6 weeks after initiation of left vagus nerve stimulation for intractable epilepsy. Her symptoms mimicked those seen in glossopharyngeal neuralgia and were relieved by temporary cessation of stimulation. Gradual reinstitution of therapy with alteration in stimulus parameters resulted in improved seizure control as well as cessation of pain symptoms. Direct stimulation of the vagus nerve may result in vagoglossopharyngeal neuralgia, which, in this case, was amenable to stimulus modification.- - - - - - - - - - ranking = 6keywords = nerve (Clic here for more details about this article) |
6/28. Fluid-fluid levels in intracranial schwannomas.Intracranial cystic neurogenic tumours constitute an uncommon subset of tumours with a distinct clinico-biological behaviour. The presence of fluid-fluid levels within the tumours, although rare, confirms the cystic nature of the neoplasms. Barring the acoustic schwannomas, cystic cranial nerve schwannomas are exceptionally uncommon. Imaging findings of fluid-fluid levels in two non-acoustic cranial nerve schwannomas are described; one was a cystic trigeminal schwannoma and the other was a glossopharyngeal nerve schwannoma. The causes of the fluid-fluid level and its implications are analysed.- - - - - - - - - - ranking = 4.9909728606277keywords = nerve, cranial nerve (Clic here for more details about this article) |
7/28. Jacobson's nerve schwannoma presenting as middle ear mass.Schwannoma is one of the common benign middle ear space tumors. Middle ear space schwannomas may originate from the nerves of the tympanic cavity or by extensions from outside the middle ear space. In the English-language literature, the facial nerve and chorda tympani nerve, but not yet the tympanic branch of glossopharyngeal nerve (Jacobson's nerve), have been reported as the origins of intrinsic middle ear space schwannomas. We present the clinical and radiologic features of a middle-space schwannoma originating from Jacobson's nerve, and suggest that such a tumor be included in the differential diagnosis of middle ear tumors.- - - - - - - - - - ranking = 10keywords = nerve (Clic here for more details about this article) |
8/28. Chiari Type I malformation presenting as glossopharyngeal neuralgia: case report.OBJECTIVE AND IMPORTANCE: Chiari Type I malformation is an important pathological state in which the brainstem is compressed by the cerebellar tonsil. We present a case of glossopharyngeal neuralgia caused by Chiari Type I malformation. CLINICAL PRESENTATION: A 50-year-old male patient was admitted with glossopharyngeal neuralgia. magnetic resonance imaging studies revealed caudal displacement of the left cerebellar tonsil. INTERVENTION: Small occipital craniectomy and C1 laminectomy were performed. The left cerebellar tonsil was resected. CONCLUSION: This glossopharyngeal neuralgia was caused by compression of the lower cranial nerves and brainstem by the displaced left cerebellar tonsil. Decompression and pain relief were obtained with resection of the cerebellar tonsil. The patient was pain-free 30 weeks after the operation.- - - - - - - - - - ranking = 1.9954864303139keywords = nerve, cranial nerve (Clic here for more details about this article) |
9/28. Surgical treatment of glossopharyngeal neuralgia as vascular compression syndrome via transcondylar fossa (supracondylar transjugular tubercle) approach.OBJECTIVE: These are the first reported cases in whom the transcondylar fossa approach was applied for the treatment of glossopharyngeal neuralgia (GPN) as a vascular compression syndrome. CASES PRESENTATION: All three cases presented with severe paroxysmal pharyngeal pain which could not be controlled by medical treatment. The patients all underwent microvascular decompression surgery (MVD) via transcondylar fossa approach. The posterior inferior cerebellar artery or the anterior inferior cerebellar artery was clearly verified to be compressing the glossopharyngeal nerve and then was safely and completely moved and fixed to the dura mater by the sling retraction technique to effect decompression. No patient has since experienced any further pain or permanent neurological deficit after surgery. TECHNICAL ADVANTAGE: The transcondylar fossa approach is one of the lateral approaches which is different from the transcondylar approach. In this approach, the posterior part of the jugular tubercle is extradurally removed without injuring the atlanto-occipital joint. The entire course of the cisternal portion of the glossopharyngeal nerve can be sufficiently seen with gentle retraction of the cerebellar hemisphere, when using this approach. CONCLUSION: This approach makes the MVD for GPN both effective and safe.- - - - - - - - - - ranking = 2keywords = nerve (Clic here for more details about this article) |
10/28. Sensory neuropathy of the trigeminal, glossopharyngeal, and vagal nerves in sjogren's syndrome.Isolated cranial nerve involvement in primary sjogren's syndrome (primary SS) has rarely been described. We report the case of a patient with sensory neuropathy of the trigeminal and also the glossopharyngeal and vagal nerves, which has not been identified previously. The electrophysiological findings in our patient with primary SS confirmed trigeminal sensory neuropathy with abnormal blink reflexes and abnormal cutaneous masseter inhibitory reflexes.- - - - - - - - - - ranking = 6.9954864303139keywords = nerve, cranial nerve (Clic here for more details about this article) |
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