Ramsay Hunt syndrome (RHS) is characterized by herpes zoster oticus, facial nerve palsy, and vestibulocochlear symptoms. Dysphagia caused by the involvement of multiple cranial nerves (CNs) in RHS is very rare. We encountered a rare case presented with severe dysphagia due to cranial polyneuropathy involving trigeminal nerve (CN V), facial nerve (CN VII), vestibulocochlear nerve (CN VIII), glossopharyngeal nerve (CN IX), vagus nerve (CN X), and hypoglossal nerve (CN XII) in RHS. This case report suggested that the prognosis for dysphagia in RHS seems favorable, and swallowing rehabilitation therapy could be beneficial in expediting tube removal.
Cranial Nerves ; Deglutition ; Deglutition Disorders* ; Facial Nerve ; Glossopharyngeal Nerve ; Herpes Zoster Oticus* ; Hypoglossal Nerve ; Paralysis ; Polyneuropathies* ; Prognosis ; Rehabilitation ; Trigeminal Nerve ; Vagus Nerve ; Vestibulocochlear Nerve

Ramsay-Hunt syndrome is caused by varicella zoster virus infection in the geniculate ganglion of the facial nerve. It is characterized by facial palsy, otic pain, and herpetic vesicles around the auricle and external auditory canal. Additionally, symptoms may develop related to other cranial nerve involvement, such as dizziness or hearing loss by the vestibulocochlear nerve being invaded. We report a rare case of a Ramsay-Hunt syndrome patient who developed dysphagia due to multiple cranial nerve involvement including the glossopharyngeal nerve and vagus nerve.
Cranial Nerves ; Deglutition Disorders ; Dizziness ; Ear Canal ; Facial Nerve ; Facial Paralysis ; Geniculate Ganglion ; Glossopharyngeal Nerve ; Hearing Loss ; Herpes Zoster Oticus ; Herpesvirus 3, Human ; Humans ; Vagus Nerve ; Vestibulocochlear Nerve

OBJECTIVE: To investigate the anatomical structures of cranial nerves in the cerebellopontine angle region to offer anatomical data for clinical operation. METHOD: A total of 52 adult cadaveric heads fixed in 10% formalin were used for this study. After cutting cerebellum and meningeal between transverse and sigmoid sinus, simulate operating method of retrosigmoid approach to observe the cranial nerves. RESULT: External diameter and length of left V, VII, VIII, IX cranial nerves are (2.54 +/- 0.84) mm and (6.79 +/- 2.51) mm, (1.18 +/- 0.31) mm and (9.89 +/- 2.66) mm, (2.17 +/- 0.52) mm and (9.92 +/- 2.61) mm, (0.77 +/- 0.24) mm and (10.34 +/- 3.12) mm respectively. External diameter and length of right V , VII, VIII, IX cranial nerves are (2.52 +/- 0.86) mm and (6.91 +/- 2.66) mm, (1.14 +/- 0.31) mm and (10 +/- 2.96) mm, (2.13 +/- 0.63) m and (10.09 +/- 2.93) mm, (0.790.29) mm and (10.17 +/- 3.06) mm. intermedius nerve locate between facial nerve and acoustic nerve, external diameter of intermedius nerve is (0.47 +/- 0.91) mm (left) and (0.37 +/- 0.07) mm (right). Length of vagal nerve is (10.44 +/- 2.57) mm (left), (9.91 +/- 2.91) mm (right), rootlets of f vagal nerve is 6.37 +/- 2.26 (left) and 6.33 +/- 2.38 (right). external diameter of accessory nerve is (0.76 +/- 0.16) mm (left) and (0.81 +/- 0.19) mm (right). CONCLUSION This study provide anatomical data for retrosigmoid approach in the cerebellopontine angle region.
Adult ; Cerebellopontine Angle ; anatomy & histology ; Cranial Nerves ; anatomy & histology ; Cranial Sinuses ; anatomy & histology ; surgery ; Facial Nerve ; anatomy & histology ; Glossopharyngeal Nerve ; anatomy & histology ; Humans ; Vestibulocochlear Nerve ; anatomy & histology

Ramsay-Hunt syndrome is an infectious disease caused by the varicella zoster virus. It is usually associated with facial and vestibulocochlear nerve palsy, but other cranial nerve dysfunction can be accompanied. We present a 68-year-old woman with abducens nerve palsy associated with Ramsay-Hunt syndrome. She showed abduction limitation of left eye with peripheral facial palsy and vestibulopathy of the left side. Varicella zoster virus polymerase chain reaction of cerebrospinal fluid was positive and internal auditory canal magnetic resonance imaging was revealed enhancement of labyrinthine segment of left facial nerve. Although abducens nerve palsy is uncommon feature of Ramsay-Hunt syndrome, but it can be developed by several different mechanisms.
Abducens Nerve Diseases ; Abducens Nerve ; Aged ; Cerebrospinal Fluid ; Communicable Diseases ; Cranial Nerves ; Facial Nerve ; Facial Paralysis ; Female ; Herpesvirus 3, Human ; Humans ; Magnetic Resonance Imaging ; Paralysis ; Polymerase Chain Reaction ; Vestibulocochlear Nerve

OBJECTIVE: Jugular foramen schwannomas are uncommon pathological conditions. This article is constituted for screening these tumors in a wide perspective. MATERIALS: One-hundred-and-ninty-nine patients published in 19 articles between 1984 to 2007 years was collected from Medline/Index Medicus. RESULTS: The series consist of 83 male and 98 female. The mean age of 199 operated patients was 40.4 years. The lesion located on the right side in 32 patients and on the left side in 60 patients. The most common presenting clinical symptoms were hearing loss, tinnitus, disphagia, ataxia, and hoarseness. Complete tumor removal was achieved in 159 patients. In fourteen patients tumor reappeared unexpectedly. The tumor was thought to originate from the glossopharyngeal nerve in forty seven cases; vagal nerve in twenty six cases; and cranial accessory nerve in eleven cases. The most common postoperative complications were lower cranial nerve palsy and facial nerve palsy. Cerebrospinal fluid leakage, meningitis, aspiration pneumonia and mastoiditis were seen as other complications. CONCLUSION: This review shows that jugular foramen schwannomas still have prominently high morbidity and those complications caused by postoperative lower cranial nerve injury are life threat.
Accessory Nerve ; Ataxia ; Cranial Nerve Diseases ; Cranial Nerve Injuries ; Cranial Nerves ; Facial Nerve ; Female ; Glossopharyngeal Nerve ; Hearing Loss ; Hoarseness ; Humans ; Male ; Mass Screening ; Mastoid ; Mastoiditis ; Meningitis ; Neurilemmoma ; Paralysis ; Pneumonia, Aspiration ; Postoperative Complications ; Tinnitus

PURPOSE: To assess the radiologic response and cranial nerve morbidity in intracranial schwannoma patients treated with stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT). MATERIALS AND METHODS: Twenty-six patients with intracranial schwannoma were treated with linear accelerator- based SRS or FSRT between February 1995 and October 1999. The origin of schwannoma was acoustic nerve in twenty-one patients, facial nerve in two, trigeminal nerve in two, and glossopharyngeal nerve in one. SRS were performed with the median peripheral dose of 14 Gy (range 12-16), and FSRT were done with the median peripheral dose of 25 2 Gy (range 50-60). RESULTS: With a median follow-up period of 33 months (range 12-67), the local control rate was 100%. Tumorregression was noted in eleven patients, and tumor stabilization was found in the remaining fifteen. Useful hearing preservation was achieved in two of three patients. Facial nerve neuropathy was shown in two patients and one patients developed trigeminal nerve neuropathy. CONCLUSION: Stereotactic radiotherapy including SRS and FSRT provided excellent local control in intracranial schwannoma. It shows the possibility of a high rate of hearing preservation and an acceptable neurotoxicity, although the number of patients are small and follow-up is relatively short.
Cochlear Nerve ; Cranial Nerves ; Facial Nerve ; Follow-Up Studies ; Glossopharyngeal Nerve ; Hearing ; Humans ; Neurilemmoma* ; Radiosurgery* ; Radiotherapy* ; Trigeminal Nerve

It is well known that M. leprae involves peripheral nerves, but it is a few known that M. leprae involves craninal nerves. I experienced one case of relapsed leprosy accompanied by multiple cranial nerve palsies. Revealed symptoms are to involve trigeminal nerve (V). facial nerve (VII), vestibular nerve (VIII), glossopharyngeal nerve (IX), vagus nerve (X). It is not effect to treat with corticosteroid, but is good effect to treat with MDT(multiple drug therapy)
Cranial Nerve Diseases* ; Cranial Nerves* ; Dystroglycans ; Facial Nerve ; Glossopharyngeal Nerve ; Leprosy* ; Peripheral Nerves ; Trigeminal Nerve ; Vagus Nerve ; Vestibular Nerve

Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few reference textbooks available in the field. This review article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: optic, facial, vagus and spinal accessory nerves. The relevant literatures and potential future applications are discussed.
Accessory Nerve ; Cranial Nerves* ; Peripheral Nerves ; Ultrasonography*

Herpes Zoster Oticus is an infectious cranial polyneuropathy caused by varicella zoster, the herpetic virus that also causes chicken pox and shingles. Its symptoms include facial paralysis, ear pain, and an auricular vesicle. This syndrome can affect any cranial nerve and usually affects multiple nerves, causing central, cervical, and peripheral effects. Most commonly affected cranial nerves are facial nerve (VII) and vestibulocochlear nerve (VIII). With a review of literature, we report two rare cases. First case involves cranial nerve VII, VIII, IX, X and second case involves cranial nerve VIII, IX, X, which characteristically does not involve facial nerve.
Chickenpox ; Cranial Nerves* ; Ear ; Facial Nerve ; Facial Paralysis ; Herpes Zoster Oticus* ; Herpes Zoster* ; Herpesvirus 3, Human ; Polyneuropathies ; Vestibulocochlear Nerve

Intracranial schwannoma constitutes 8-10% of all primary intracranial tumors. The majority of them derive from cranial nerves, especially from the vestibulocochlear nerve. Intraparenchymatous schwannoma of the cent ral nervous system, on the other hand, is very rare. We report a rare case of brainstem schwannoma with the review of literature 8.
Brain Stem* ; Cranial Nerves ; Hand ; Nervous System ; Neurilemmoma* ; Vestibulocochlear Nerve