11/39. Unusual clinical variants and signs in guillain-barre syndrome.Limited regional forms of the guillain-barre syndrome (GBS) and unusual focal signs or symptoms that resemble other illnesses are described: pharyngeal-cervical-brachial weakness with ptosis, sparing power, and reflexes in the legs; paraparesis with normal power and reflexes in the arms; early severe ptosis without other signs of oculomotor weakness; and acute severe midline back pain at the onset. The first two variants did not progress to typical generalized GBS, delaying the proper diagnosis. Regional and functional variants suggest that the pathologic, and perhaps immunologic abnormalities of GBS can be localized and selective.- - - - - - - - - - ranking = 1keywords = pharyngeal (Clic here for more details about this article) |
12/39. Computerized tomography and Trotter's syndrome in the diagnosis of maxillofacial pain.Trotter's syndrome is a clinical triad of unilateral deafness, neuralgia affecting branches of the trigeminal nerve, and defective mobility of the soft palate, which is caused by malignant tumors involving the lateral pharyngeal recess (Rosenmuller's fossa). It is an ominous presentation, which can masquerade as dental or masticatory pain. Computerized tomography (CT) can be used not only to explain the anatomic basis of Trotter's syndrome but also to determine the extent and distribution of the malignant tumor involved. The advantages of CT over conventional radiography are illustrated by a case of adenoid cystic carcinoma that presented as Trotter's syndrome. Perineural invasion by tumor is shown on the gross level for the first time with CT, and important diagnostic considerations, which may aid in the early diagnosis of future cases, are discussed.- - - - - - - - - - ranking = 1keywords = pharyngeal (Clic here for more details about this article) |
13/39. accessory nerve schwannoma extending extracranially to the second cervical level of vertebra.We described a 67-year-old man who had a right jugular foramen tumour expanding extracranially to the level of C2 cervical body. paralysis of the glossopharyngeal, vagal, accessory, hypoglossal nerves and sensorineural hearing disturbance were found. The tumour originated from the accessory nerve and the histological examination revealed it was schwannoma. accessory nerve as an origin of the jugular foramen neurinoma and its pre-operative neurological signs are reviewed.- - - - - - - - - - ranking = 1keywords = pharyngeal (Clic here for more details about this article) |
14/39. Bilateral hypoglossal nerve palsy due to vertical subluxation of the odontoid process in rheumatoid arthritis.Two patients with rheumatoid arthritis involving the cervical spine developed a rapidly progressive dysarthria due to bilateral hypoglossal nerve palsies, in one patient as an isolated lesion, and in the other in conjunction with dysfunction of the vagus and glossopharyngeal nerves. Both patients showed upward movement of the axis, relative to the foramen magnum, which has been termed 'vertical subluxation of the odontoid' or 'cranial settling'. Mechanical injury to the nerves, secondary to this process, is the most likely mechanism.- - - - - - - - - - ranking = 1keywords = pharyngeal (Clic here for more details about this article) |
15/39. Unusual pharyngeal lesion causing dysphagia.A 58-year-old man was evaluated for a 42-year complaint of a pharyngeal foreign body sensation whenever he ate. Examination revealed normal anatomy at rest but diffuse hypopharyngeal distension with Valsalva's maneuver. His past history was remarkable for an infectious illness, possibly diphtheria. We speculate that this unusual case most likely represents a postdiphtheritic selective pharyngeal paralysis and present his case, radiographic findings, and a discussion of the differential diagnosis.- - - - - - - - - - ranking = 7keywords = pharyngeal (Clic here for more details about this article) |
16/39. Multiple cranial nerve palsies in late metastasis of midline malignant reticulosis.A 12-year-old man had a sudden onset of multiple cranial nerve palsies after treatment for a necrotizing lesion of the soft palate two years previously. It was thought that neurologic signs were secondary to extension of the local disease and radiation therapy to the base of the brain was begun. The patient died shortly thereafter. A diffuse atypical histiocytic lymphoma involving multiple cranial nerves, lumbosacral nerves, orbital muscles, and other organs was found on autopsy. Initial nasopharyngeal biopsy and autopsy findings were compatible with midline malignant reticulosis, a malignant lesion of the upper airway sometimes associated with metastasis. Our case is the first reported autopsy-documented case, to the best of our knowledge, of metastatic involvement of the cranial nerves in midline malignant reticulosis.- - - - - - - - - - ranking = 1keywords = pharyngeal (Clic here for more details about this article) |
17/39. Olivopontocerebellar atrophy with velopharyngolaryngeal paralysis: a contribution to the somatotopy of the nucleus ambiguus.The authors report a case of olivopontocerebellar atrophy (OPCA) with velopharyngolaryngeal paralysis. The cerebellar syndrome appeared in a 66 year-old woman and ran its course until her death at 75. The velopharyngolaryngeal paralysis occured two years after the beginning of the cerebellar symtomatology and was limited for 6 months to a Gerhardt syndrome. Postmortem examination showed typical lesions of OPCA, and on serial sections of the medulla a massive loss of neurons in the lower two thirds of the nucleus ambiguus, bilaterally. The association of OPCA with velopharyngolaryngeal paralysis is exceptional. The anatomical findings in this case contribute to the somatotopy of the nucleus ambiguus in man by demonstrating the location of the velopharyngolaryngeal centers in this formation. The upper third plays only an accessory role in the velopharyngolaryngeal functions, and in the two lower thirds one finds, from the oral to the caudal extremity, first the velopharyngeal, then the laryngeal centers.- - - - - - - - - - ranking = 1keywords = pharyngeal (Clic here for more details about this article) |
18/39. Cricopharyngeal myotomy in pharyngeal paralysis. Cineradiographic and manometric indications.A brief outline of the causes and symptoms of hypopharyngeal paresis is followed by a discussion of the diagnostic possibilities of manometry and cineradiography. It was found that the pharyngoesophageal sphincter mechanism remains intact in the case of complete paralysis of the hypopharynx. When there are severe symptoms of dysphagia, myotomy of the pharyngoesophageal sphincter is to be considered on the basis of these diagnostic findings. This procedure can lead to substantial improvement of the symptoms. Sphincterotomy yielded very favorable results in five out of nine patients, two of whom are discussed in some detail by way of illustration.- - - - - - - - - - ranking = 9keywords = pharyngeal (Clic here for more details about this article) |
19/39. Isolated temporary pharyngeal paralysis in childhood.Three children developed dysphagia and rhinolalia indicating isolated paralysis of the ninth and tenth cranial nerves. They recovered completely after three to four weeks. The clinical features suggested an infectious aetiology.- - - - - - - - - - ranking = 4keywords = pharyngeal (Clic here for more details about this article) |
20/39. Nasopharyngeal mucormycotic osteitis: a new syndrome characterized by initial presentation of multiple cranial nerve palsies.Rhinocerebral mucormycosis, a highly lethal fungal infection of the head and neck, is commonly recognized by its classic appearance. Two cases of this newly recognized clinical syndrome with isolated unilateral peripheral cranial nerve V, VI, VII, IX, X, XI, and XII palsies and initial sparing of the eighth cranial nerve are presented. Examination revealed that each patient had ulceration of the nasopharynx and osteitis of the base of the skull. nose, orbits, paranasal sinuses, and intracranial nervous systems were initially spared. The cause of this obscure cranial nerve paralysis was diagnosed from biopsy specimens of the nasopharyngeal tissues and the demonstration of nonseptate hyphae. review of the literature did not indicate that this syndrome had previously been recognized. The name nasopharyngeal mucormycotic osteitis is suggested.- - - - - - - - - - ranking = 6keywords = pharyngeal (Clic here for more details about this article) |
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