1/10. Neuromyotonia of the abducens nerve after hypophysectomy and radiation.The clinical signs of the rarely encountered ocular neuromyotonia consist of transient involuntary tonic contraction and delayed relaxation of single or multiple extraocular muscles, resulting in episodic diplopia. With a mean time delay of 3.5 years, this motility disorder frequently follows tumor excision or adjuvant radiation near the skull base. Ocular neuromyotonia may reflect inappropriate discharge from oculomotor neurons with unstable cell membranes because of segmental demyelinization by tumor compression and radiation-induced microangiopathy. In the present paper, the authors present the case of a 53-year-old patient with a history of transsphenoidal hypophysectomy and adjuvant radiotherapy, who underwent strabismus surgery for abducens palsy.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
2/10. Aspergillus parasellar abscess mimicking radiation-induced neuropathy. Case report.BACKGROUND: Transsphenoidal surgery is a safe procedure for treatment of pituitary adenomas. However, several complications, including post-surgical infection, are known. We describe a case of Aspergillus parasellar abscess that presented with cranial neuropathies following transsphenoidal surgery and radiosurgery. We initially diagnosed the case as radiation-induced neuropathies, which delayed the detection of Aspergillus. CASE DESCRIPTION: A 55-year-old man underwent transsphenoidal surgery for a pituitary adenoma that presented with pituitary apoplexy. dexamethasone had been continuously administered for hypocortisolism probably caused by pituitary apoplexy. Four years later, radiosurgery was performed for a relapse in the right cavernous sinus. Another 4 years later, he developed painful right ophthalmoplegia, right ptosis, and bilateral visual impairment, successively. We initially suspected that the painful ophthalmoplegia and ptosis were because of radiation-induced cranial neuropathies; however, results of magnetic resonance (MR) imaging and his clinical course were not consistent with those of radiation-induced neuropathies. Therefore, we performed exploratory surgery that revealed a subdural abscess on the planum sphenoidale. culture of a specimen grew aspergillus fumigatus. CONCLUSION: Intracranial fungal abscess is a fatal complication unless it is treated early. It is thus important to consider the possibility of parasellar infection and differentiate it from radiation-induced cranial neuropathies when a patient presents with cranial neuropathies after transsphenoidal surgery and radiosurgery.- - - - - - - - - - ranking = 8keywords = radiation-induced (Clic here for more details about this article) |
3/10. Standard and novel radiotherapeutic approaches to neoplastic meningitis.Neoplastic meningitis usually occurs late in the natural history of cancer. Adequate staging and assessment of the patient's overall reserves and prognosis are crucial in determining whether aggressive treatment is justified. Although radiotherapy remains the single most effective treatment, it is considered palliative for epithelial cancers and is generally directed to sites of bulky disease that obstruct the flow of cerebrospinal fluid or cause neurologic dysfunction. Such diseases as leukemia, medulloblastoma, and germinoma are exceptions that can be treated definitively with craniospinal irradiation. Innovations in conformal therapy may help to reduce the significant amount of myelosuppression associated with spinal irradiation. The main long-term toxicity associated with whole-brain irradiation (WBI) is dementia resulting from leukoencephalopathy, which may be exacerbated when WBI is given in combination with chemotherapy. A case report highlighting the use of radiotherapy for palliation in a patient with neoplastic meningitis is presented at the end of this article.- - - - - - - - - - ranking = 0.021666566457346keywords = leukemia (Clic here for more details about this article) |
4/10. Ocular complications of sigmoid sinus thrombosis from L-asparaginase.This article presents a 9-year-old boy with acute lymphocytic leukemia who developed ocular complications after beginning treatment with L-asparaginase. Ocular motor examination revealed esotropia with a right abduction deficit, consistent with a sixth nerve palsy, and funduscopy revealed bilateral optic disc edema. thrombosis of the right sigmoid sinus was noted on magnetic resonance imaging and magnetic resonance venography. Symptoms gradually resolved after discontinuing L-asparaginase and treatment with heparin.- - - - - - - - - - ranking = 0.021666566457346keywords = leukemia (Clic here for more details about this article) |
5/10. mucormycosis presenting with painful ophthalmoplegia.mucormycosis is a rare fungal infection that can involve the sino-orbito-cerebral region. Sino-orbito-cerebral mucormycosis is most common in patients who are immunocompromised or have diabetes mellitus, severe malnutrition or burns. This condition can be fatal if it is not diagnosed early and treated aggressively. This article presents 4 cases of mucormycosis, including 2 with orbital apex syndrome, 1 with cavernous sinus syndrome, and 1 with multiple cranial nerve involvement. All of the patients were presented with painful ophthalmoplegia. The predisposing factors for mucormycosis included diabetes mellitus (three patients) and chronic leukemia (one patient). In all cases, mucormycosis was diagnosed by examining endoscopic sinus drainage material and was treated with surgical debridement and amphotericin b. Two patients with central nervous system involvement died. The others have survived, but still exhibiting various neurologic abnormalities after aggressive treatment. patients with mucormycosis rarely present with orbital apex syndrome. The possibility of mucormycosis should be investigated in any patient with painful ophthalmoplegia, and prompt otorhinolaryngologic examination is recommended to ensure rapid diagnosis and treatment.- - - - - - - - - - ranking = 0.021666566457346keywords = leukemia (Clic here for more details about this article) |
6/10. Burkitt leukemia with numb chin syndrome and cavernous sinus involvement.cavernous sinus syndrome is a rare event. Non-Hodgkin lymphomas, are one possible cause. Neurological presentation of these lymphomas is also exceptional. We report the case of an 11-year-old boy that developed a right third cranial nerve palsy and numbness in the distribution of the right mental nerve, with normal CSF, and enlargement of cavernous sinus on the same side, who was diagnosed Burkitt leukemia.- - - - - - - - - - ranking = 0.10833283228673keywords = leukemia (Clic here for more details about this article) |
7/10. Radiation-induced cranial nerve palsy: hypoglossal nerve and vocal cord palsies.Cranial nerve palsies are an unexpected complication of radiotherapy for head and neck tumours. We present a case of this radiation-induced cranial palsy. An 18-year-old female with nasopharyngeal carcinoma developed a right hypoglossal nerve palsy 42 months after cancericidal doses of radiotherapy. In addition, she developed a bilateral vocal cord palsy 62 months after therapy. Follow-up over four years has demonstrated no evidence of tumour recurrence and no sign of neurological improvement.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
8/10. Neurological manifestations as the initial presentation of acute myelogenous leukemia.This case report illustrates neurological deficits as an unusual presentation of acute myelogenous leukemia. Neurological deficits are rare early in this disease. Our patient presented with anorexia, malaise, headache, and multiple cranial nerve palsies. A high WBC count and abnormal peripheral smear led to the diagnosis of leukemia. This report demonstrates that, although rare, CNS symptoms may be the initial manifestation of leukemia. blood dyscrasias should not be overlooked in patients with the acute onset of neurological symptoms. A complete blood count and differential should be obtained under those circumstances.- - - - - - - - - - ranking = 0.15166596520142keywords = leukemia (Clic here for more details about this article) |
9/10. Cranial nerve palsy as the presenting feature of secondary plasma cell leukemia.A patient with IgA lambda multiple myeloma (MM) developed plasma cell leukemia (PCL), presenting as oculomotor nerve palsy. The cerebrospinal fluid (CSF) contained plasma cells, which double stained with fluoresceinated anti-IgA and anti-lambda antisera. The palsy was most probably due to meningeal myelomatosis. The neurologic disorder appeared to be refractory to the therapy used, although plasma cells disappeared from the peripheral blood. Secondary plasma cell leukemia is a rare complication of MM, usually occurring in the terminal stage of the disease. Those patients may be eligible for central nervous system (CNS) prophylaxis, as is commonly performed in patients with other types of leukemia.- - - - - - - - - - ranking = 0.15166596520142keywords = leukemia (Clic here for more details about this article) |
10/10. Spontaneous remission of papilledema and sixth nerve palsy in acute lymphoblastic leukemia.Spontaneous regression of hematologic malignancies is not uncommon and occurs in a wide variety of lymphomas and leukemias. In contrast, spontaneous remission of neurologic symptoms produced by these tumors is exceedingly rare. We report a patient with central nervous system acute lymphoblastic leukemia who experienced at least one spontaneous remission of papilledema and sixth nerve palsy. This represents, to our knowledge, the first case of spontaneous remission of neuro-ophthalmologic signs in a patient with acute leukemia. We conclude that meningeal leukemia may have a protracted course, and that spontaneous remission of neuro-ophthalmologic findings should not be so readily ascribed to a benign process in a patient with preexisting leukemia.- - - - - - - - - - ranking = 0.19499909811611keywords = leukemia (Clic here for more details about this article) |
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