Clinical reasoning: Multiple cranial neuropathies in a young man.
case_report · Level V
Where this comes from
- Record sourced from PubMed, PMID 23382371.
- Also identified by DOI 10.1212/WNL.0b013e3182815441 and PMC identifier 3589290.
- No licence information is recorded for this record.
- Because redistribution is not established, this page shows the abstract only. Follow the links below for the full text.
Abstract
A 19-year-old man with no significant medical history noted 3 weeks of right facial numbness and slurred speech. On examination, he had decreased sensation in the right middle and lower trigeminal nerve distributions, right tongue deviation, and bilateral facial weakness. A lumbar puncture yielded CSF with a lymphocytic predominant pleocytosis (50 leukocytes/mm<sup>3</sup>, 95% lymphocytes), elevated protein (260 mg/dL), and normal glucose (49 mg/dL), without other evidence of inflammation or infection, while serum studies were normal. Brain MRI with gadolinium demonstrated a subcentimeter left frontal subcortical white matter lesion on fluid-attenuated inversion recovery images and a nonenhancing pineal cyst.
Medical subject headings
- Brain Neoplasms
- Cranial Nerve Diseases
- Germinoma
- Spinal Cord Neoplasms