Please use this identifier to cite or link to this item: https://dora.health.qld.gov.au/qldresearchjspui/handle/1/563
Title: A case of bilateral lower cranial nerve palsies after base of skull trauma with complex management issues: Case report and review of the literature
Authors: Grimley, Rohan 
Lehn, Alexander 
Lettieri, J.
Issue Date: 2012
Source: May 18, (3), 2012, p. 152-154
Pages: 152-154
Journal: Neurologist
Abstract: INTRODUCTION: Fractures of the skull base can cause lower cranial nerve palsies because of involvement of the nerves as they traverse the skull. A variety of syndromes have been described, often involving multiple nerves. These are most commonly unilateral, and only a handful of cases of bilateral cranial nerve involvement have been reported. CASE REPORT: We describe a 64-year-old man with occipital condylar fracture complicated by bilateral palsies of IX and X nerves associated with dramatic physiological derangement causing severe management challenges. Apart from debilitating postural hypotension, he developed dysphagia, severe gastrointestinal dysmotility, issues with airway protection as well as airway obstruction, increased oropharyngeal secretions and variable respiratory control. CONCLUSIONS: This is the first report of a patient with traumatic bilateral cranial nerve IX and X nerve palsies. This detailed report and the summary of all 6 previous case reports of traumatic bilateral lower cranial nerve palsies illustrate clinical features, treatment strategies, and outcomes of these rare events. Copyright 2012 by Lippincott Williams & Wilkins.
DOI: http://dx.doi.org/10.1097/NRL.0b013e318247bb6f
514
Resources: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=emed10&AN=2012282777
Keywords: glossopharyngeal nervejugular foramen;occipital bone;skull fractures;vagus nerve;adult;airway obstruction;article;case report;clinical feature;cranial nerve paralysis;disease association;dysphagia;enteric feeding;follow up;gastrointestinal motility disorder/dt [Drug Therapy];gastrointestinal motility disorder/su [Surgery];gastrointestinal motility disorder/th [Therapy];human;hypokalemia;injury severity;male;medical literature;oropharynx;orthostatic hypotension;outcome assessment;priority journal;respiration control;respiratory alkalosis;skull base;skull base fracture;syncope;systolic blood pressure;unconsciousness;atropine;botulinum toxin;glycopyrronium bromide;metoclopramide/dt [Drug Therapy]
Type: Article
Appears in Sites:Sunshine Coast HHS Publications

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