1/14. Numb chin syndrome as the presenting symptom of metastatic prostate carcinoma.We report a case of the numb chin syndrome as the presenting symptom in a patient with metastatic prostate carcinoma. The numb chin syndrome is characterized by facial numbness along the distribution of the mental branch of the trigeminal nerve. Most cases of this syndrome that are not dental in origin have been associated with diffuse metastatic disease, particularly with underlying lymphoproliferative and breast cancer. Although axial and vertebral bone metastases are common in patients with carcinoma of the prostate, mental nerve involvement is rare. We present a case of the numb chin syndrome as the initial clinical manifestation in a patient with metastatic prostate adenocarcinoma.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
2/14. Mental neuropathy: report of five cases and review of the literature.Mental nerve neuropathy, also referred to as numb chin syndrome, is a rare, seemingly harmless symptom. It is more often associated with cancer, either as first symptom or during the outcome, than with benign diseases. In this review, we will focus on the numb chin syndrome presenting as an isolated neurological symptom. We report five patients with mental nerve neuropathy associated with metastatic disease (small cell lung cancer, prostatic cancer and breast cancer). In one patient, numb chin syndrome preceded the discovery of the disease, while, in the four others, it occurred as a sign of relapse or progression. Isolated mental nerve neuropathy, frequently associated with breast cancer and lymphoproliferative diseases, is generally thought to be the consequence of bone metastases or leptomeningeal seeding, but may also present without an obvious cause, most often secondary to the involvement of the mental nerve itself. Although various therapies may lead to the resolution of this symptom, median survival after diagnosis is generally less than 1 year. The appearance of a mental nerve neuropathy should never be considered as a 'banal' symptom and investigations to detect a possible cancer should be mandatory.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
3/14. Anaesthesia of the right lower hemilip as a first manifestation of multiple myeloma. Presentation of a clinical case.multiple myeloma is a malignant proliferation of plasma cells. It may affect any of various bones, causing osteolytic lesions with a characteristic "punched out" radiographic appearance. The commonest symptom is bone pain. One of the most frequent locations is the mandible. Symptoms of multiple myeloma of the mandible include tumefaction, non-specific pain, tooth mobility and sometimes loss, and paraesthesia of the dental nerve. Here we report a case of multiple myeloma of the mandible which was unusual in that the presenting complaint was anaesthesia of the right lower hemilip.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
4/14. A rare case of lumbosacral meningioma: nondural attachment and possible enlargement by orally administered sex steroid.STUDY DESIGN: A case report is presented. OBJECTIVES: To present a very rare case of orally ingested sex hormone pills inducing nondurally attached meningioma in the lumbosacral region. SUMMARY OF BACKGROUND DATA: Meningiomas are known to enlarge in response to female sex hormones. At this writing, few cases of nondurally based intradural meningioma have been reported. Moreover, meningiomas in the lumbosacral region are very rare. Spinal meningiomas predominantly arise in the fourth to sixth decades of life and are more common in women. methods: The patient was a 20-year-old woman. She had undergone oral sex steroid therapy for long-term oligomenorrhea. The patient complained of intolerable lumbago and numbness in her buttocks. Nonopioid analgesics did not relieve her pain, and she was unable to walk without the aid of a walker. radiography disclosed a lumbosacral intradural tumor. RESULTS: Complete removal of the tumor was performed. The tumor was not adherent to the dura, and its appearance was that of a typical neurilemmoma. However, the pathologic diagnosis was meningioma. CONCLUSIONS: The tumor in the reported case may have enlarged in response to orally ingested sex steroid pills. Nondural attachment intradural meningiomas are quite uncommon. The gross appearance of the tumor during surgery was typical of neurilemmoma. All the cases reported so far, including the current case, have involved tumor located in the lumbosacral region. Care must be taken in the management of lumbosacral intradural tumors because tumors resembling neurilemmoma may in fact represent meningioma, some subtypes of which possess a high rate of recurrence.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
5/14. Spinal osteochondromas in middle-aged to elderly patients.STUDY DESIGN: Three case reports of solitary spinal osteochondromas in middle-aged and elderly patients. OBJECTIVES: To describe the treatment of three rare cases of spinal osteochondromas in patients significantly older than the cases previously reported in the literature. SUMMARY OF BACKGROUND DATA: Osteochondromas arising in the vertebral column are considered rare. The mean age of clinical appearance is said to be in the second or third decade of life. methods: Clinical history, physical examinations, plain radiographs, magnetic resonance imaging, myelography, computed tomographic myelography, and histopathologic findings for each case were reviewed in conjunction with previous cases reported in the literature. RESULTS: Total removal of the tumor was effective in causing the symptoms to disappear. CONCLUSIONS: Spinal osteochondromas are rare and tend to appear in young adults. Three cases of spinal osteochondromas that were unusual in terms of age at clinical presentation and localization were reported, suggesting a continuous growth of the tumor beyond skeletal maturity.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
6/14. Galloping ophthalmoplegia and numb chin in burkitt lymphoma.A 57-year-old man developed complete bilateral ophthalmoplegia over a period of 10 days, together with bilateral facial pain and numbness of the chin. He had no other clinical manifestations. Findings on brain magnetic resonance imaging and spinal fluid formula from the first lumbar puncture were normal, but cerebrospinal fluid flow cytometry disclosed a kappa restriction monoclonal B-cell population, indicating malignant lymphoma. Computed tomography of the chest, abdomen, and pelvis then revealed multiple enlarged lymph nodes. biopsy of an inguinal node showed findings consistent with burkitt lymphoma. Within six weeks, intravenous and intrathecal chemotherapy resolved all neurologic findings except a partial right-side sixth nerve palsy and mild chin numbness. Eighteen months after disease onset, the patient remained in remission. Meningeal spread of burkitt lymphoma is not commonly a presenting feature in immunocompetent adults. chin numbness, a characteristic feature caused by infiltration of the mental nerve, should facilitate earlier recognition, which may be life saving.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
7/14. Severe interscapular pain and increased creatine kinase activity: the answer was in the ankles.Severe thoracic back pain with increased creatine kinase activity is a clinical presentation that suggests a variety of life threatening conditions. If initial examination is unrevealing, multiple diagnostic tests are usually performed attempting to identify the origin of the problem, sometimes neglecting apparently unrelated subtle physical findings. A patient is described in whom this was the initial presentation of a sensory demyelinating neuropathy, resulting in a diagnostic challenge. This case expands the differential diagnosis of severe thoracic back pain and increased creatine kinase activity, and illustrates the importance of physical examination in reaching a final diagnosis.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
8/14. Bilateral traumatic neuroma of the anterior cervical nerve root: case report.STUDY DESIGN: Case report. OBJECTIVES: A rare case of anterior cervical second root traumatic neuroma with no history of trauma is reported, and possible etiology is discussed. SUMMARY OF BACKGROUND DATA: Traumatic neuroma is the reactive, nonneoplastic proliferation in the injured nerve. Several atypical locations of traumatic neuroma have been reported. To date, only 4 cervical traumatic neuroma cases with no history of trauma have been reported, and, to our knowledge, there is no case of bilateral cervical traumatic neuroma published in the literature. methods: A patient with a history of neck and left upper extremity pain, who had hypoesthesia in left C2 dermatome on neurologic examination is presented. A left C2-C3 hemilaminectomy and tumor extirpation were performed. RESULTS: A histopathologic study revealed features of a typical traumatic neuroma. The patient had no deficits on her postoperative neurologic examination, and her neck and left arm pain improved. The unusual location of this lesion and possible etiology of such a traumatic neuroma are discussed. CONCLUSIONS: A rare case of anterior bilateral cervical second root traumatic neuroma with no history of trauma is reported. An unnoticed history of trauma may play an etiologic role in the development of these lesions.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
9/14. The numb chin syndrome as an early manifestation of giant-cell (temporal) arteritis: a case report.We describe a 70-year-old woman with a 2-month history of a numb chin and gradually increasing bilateral headache and malaise. Neurological examination disclosed chin hypoesthesia while investigations showed a normocytic anemia, ESR of 100, and CRP of 72. A CT brain scan, chest X-ray, and bone scan showed no evidence of malignancy. Temporal arteritis was suspected and prednisolone started with prompt resolution of the headache, chin hypoesthesia, ESR, and CRP. This case illustrates an unusual etiology of the numb chin syndrome, which in most occasions is associated with malignancy. Temporal arteritis should be borne in mind as a possible explanation for this as it is a treatable condition with potentially serious, life-threatening complications.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
10/14. Unilateral hypoplasia of the trigeminal ganglion.CASE REPORT: We report a case of unilateral anaesthesia of the V1 (ophthalmic) division of the trigeminal cranial nerve presenting with persistent corneal erosions and ulceration secondary to trigeminal ganglion hypoplasia. The patient had a lifelong history of unexplained left-sided ophthalmic symptoms for which numerous diagnoses were provided. Cranial nerve testing demonstrated partial trigeminal dysfunction on the left side. Further investigation eliminated viral etiologies, and subsequent magnetic resonance imaging determined that the patient had a hypo-plastic left trigeminal ganglion. COMMENTS: We present the case to alert clinicians to the possibility of this rare condition.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
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