1/32. peroneal nerve palsy caused by intraneural ganglion.A case of peroneal nerve palsy caused by an intraneural ganglion is presented. The cystic mass was located posterolateral to the lateral femoral condyle and extended along the common peroneal nerve distal to the origin of the peroneus longus muscle. The nerve was compressed in the narrow fibro-osseous tunnel against the fibula neck and the tight origin of the peroneus longus muscle. The nerve was decompressed by complete tumor excision and transection of the origin of the peroneus longus muscle. Full recovery of nerve function was obtained in 6 months.- - - - - - - - - - ranking = 1keywords = ganglion (Clic here for more details about this article) |
2/32. Palatal tremor, progressive multiple cranial nerve palsies, and cerebellar ataxia: a case report and review of literature of palatal tremors in neurodegenerative disease.We describe a patient with an unusual clinical presentation of progressive multiple cranial nerve palsies, cerebellar ataxia, and palatal tremor (PT) resulting from an unknown etiology. magnetic resonance imaging showed evidence of hypertrophy of the inferior olivary nuclei, brain stem atrophy, and marked cerebellar atrophy. This combination of progressive multiple cranial nerve palsies, cerebellar ataxia, and PT has never been reported in the literature. We have also reviewed the literature of PT secondary to neurodegenerative causes. In a total of 23 patients, the common causes are sporadic olivopontocerebellar atrophy (OPCA; 22%), Alexander's disease (22%), unknown etiology (43.4%), and occasionally progressive supranuclear palsy (4.3%) and spinocerebellar degeneration (4.3%). Most patients present with progressive cerebellar ataxia and approximately two thirds of them have rhythmic tremors elsewhere. Ear clicks are observed in 13% and evidence of hypertrophy of the inferior olivary nucleus in 25% of the patients. The common neurodegenerative causes of PT are OPCA/multiple system atrophy, Alexander's disease, and, in most of them, the result of an unknown cause.- - - - - - - - - - ranking = 0.010081421844557keywords = nucleus (Clic here for more details about this article) |
3/32. Isolated trochlear nerve palsy in patients with multiple sclerosis.The authors describe five patients with trochlear nerve palsy and MS to characterize this rare association. In two patients, trochlear nerve palsy was the initial clinical manifestation of MS. In the other three patients, this sign occurred after previous neurologic events. MRI did not identify a lesion of the fourth nerve nucleus or fascicle. ophthalmoplegia resolved within 2 months in four of the five patients. A reason this association is rare is that the fascicular course of the trochlear nerve is exposed to little myelin.- - - - - - - - - - ranking = 0.010081421844557keywords = nucleus (Clic here for more details about this article) |
4/32. Ocular signs due to an oculomotor intranuclear lesion: palsy of adduction and contralateral eye elevation.Reports on ocular signs of discrete oculomotor nuclear lesions have been rare. This is a case report of a patient with the sudden onset of limited adduction on the left side and bilateral elevation palsy, more pronounced on the right side. The symptoms lasted for 3 days. neuroimaging study did not reveal a responsible lesion. The patient was diagnosed as having a lacunar infarct. It is neuroanatomically established that the oculomotor subnucleus to the superior rectus muscle primarily cross-innervates the muscle. The palsy of adduction and contralateral supraduction is most plausibly explained by a partial oculomotor nuclear lesion. This patient demonstrated the intranuclear close arrangement of the nerves for the superior and medial rectus muscles. This case reminds us of the clinical importance of basic anatomy based neurological examinations in this computer orientated, high tech era.- - - - - - - - - - ranking = 0.010081421844557keywords = nucleus (Clic here for more details about this article) |
5/32. Asymmetric sweating in a child with multiple sclerosis.A 10-year-old male with multiple sclerosis complained of excessive sweating on the right side of the forehead and shoulder on relapse 3 months after the onset of multiple sclerosis. Because the neurologic evaluation revealed no abnormalities in the sudomotor function, it is likely that the hyperhidrosis resulted from a lesion in the central or preganglionic sympathetic nervous system. magnetic resonance imaging demonstrated a high-intensity lesion involving the left hypothalamus on T(2)-weighted imaging. Thus hypothalamic involvement might be the reason for the hyperhidrosis in this patient.- - - - - - - - - - ranking = 0.2keywords = ganglion (Clic here for more details about this article) |
6/32. Docetaxel-induced nail changes--a neurogenic mechanism: a case report.Docetaxel is a new taxoid widely used in chemotherapy for advanced breast cancer and other solid malignancies. Painful nail changes with onycholysis occur in about 40% of docetaxel-treated patients as a prominent adverse effect. We report a patient with a complete peripheral palsy of the right arm due to advanced breast cancer with diffuse tumor infiltration of the brachial plexus. Treatment with docetaxel led to onycholysis at all extremities except the paretic hand. Sensory and motoric innervation measured by nerve conduction studies showed a complete loss of large nerve fiber function of the right arm. Function of deep mechanosensitive A beta-fibers (quantitative vibrametry) was severely decreased, but not absent. Sympathetic reflexes (induced by deep inspiration and measured with laser Doppler flowmetry) were absent on the right side and skin temperature was decreased consistent with a complete sympathetic denervation. Small afferent fibers investigated by quantitative thermotesting revealed a total loss of thermal and pain sensation. Furthermore, iontophoresis of histamine failed to induce any axon reflex-vasodilatation indicating a complete peripheral degeneration of small fiber afferents. In summary, a severe denervation of small and large fibers of the right upper limb was revealed. These results indicate that integrity of peripheral nerves seems to be a substantial factor for docetaxel-mediated nail changes. The role of an inflammatory process in onycholysis maintained by postganglionic sympathetic terminals and nociceptive C-fiber afferents is discussed. In accordance with this hypothesis, a cyclooxygenase-2 inhibitor improved nail alterations of the non-paretic limbs.- - - - - - - - - - ranking = 0.2keywords = ganglion (Clic here for more details about this article) |
7/32. Difference in neuropathogenetic mechanisms in human furious and paralytic rabies.Whereas paralysis is the hallmark for paralytic rabies, the precise pathological basis of paralysis is not known. It is unclear whether weakness results from involvement of anterior horn cells or of motor nerve fibers. There is also no conclusive data on the cause of the neuropathic pain which occurs at the bitten region, although it has been presumed to be related to sensory ganglionopathy. In this study, six laboratory-proven rabies patients (three paralytic and three furious) were assessed clinically and electrophysiologically. Our data suggests that peripheral nerve dysfunction, most likely demyelination, contributes to the weakness in paralytic rabies. In furious rabies, progressive focal denervation, starting at the bitten segment, was evident even in the absence of demonstrable weakness and the electrophysiologic study suggested anterior horn cell dysfunction. In two paralytic and one furious rabies patients who had severe paresthesias as a prodrome, electrophysiologic studies suggested dorsal root ganglionopathy. Postmortem studies in two paralytic and one furious rabies patients, who had local neuropathic pain, showed severe dorsal root ganglionitis. Intense inflammation of the spinal nerve roots was observed more in paralytic rabies patients. inflammation was mainly noted in the spinal cord segment corresponding to the bite in all cases; however, central chromatolysis of the anterior horn cells could be demonstrated only in furious rabies patient. We conclude that differential sites of neural involvement and possibly different neuropathogenetic mechanisms may explain the clinical diversity in human rabies.- - - - - - - - - - ranking = 0.6keywords = ganglion (Clic here for more details about this article) |
8/32. Combined trochlear nerve palsy and internuclear ophthalmoplegia.We report a case of left superior oblique palsy combined with a right internuclear ophthalmoplegia. A right mesencephalic lesion involving the trochlear nerve nucleus (or its fibers prior to decussation) and the medial longitudinal fascicle was hypothesized. magnetic resonance imaging showed a lesion at the suspected level.- - - - - - - - - - ranking = 0.010081421844557keywords = nucleus (Clic here for more details about this article) |
9/32. A case of unilateral opercular syndrome associated with a subcortical lesion.A patient who developed a unilateral opercular syndrome following a cerebrovascular accident is described. Computed tomography showed that the lesion did not affect the opercular cortex, but involved deep white matter and the head of the caudate nucleus of the left hemisphere. Persistent hypophonia and transient aphasia were associated. Comparison with previous cases is discussed.- - - - - - - - - - ranking = 0.010081421844557keywords = nucleus (Clic here for more details about this article) |
10/32. diagnosis of radial nerve palsy caused by ganglion with use of different imaging techniques.Clinical features of six cases of radial nerve compression syndrome as a result of ganglion at the elbow are reported. The usefulness of different imaging techniques for detecting the location of ganglion is compared. The posterior interosseous nerve was involved in two patients, the radial sensory nerve in one patient, and both nerves in three patients. ultrasonography, computed tomography, and magnetic resonance imaging revealed the location of the ganglion in every patient. ultrasonography was most convenient for screening examination when it was difficult to clearly define a ganglion by palpation. In all patients, a ganglion arose from the anterior capsule of the elbow joint. Dynamic factors in addition to compression of the nerve by ganglion may influence occurrence of the nerve palsy.- - - - - - - - - - ranking = 2keywords = ganglion (Clic here for more details about this article) |
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