Petrositis with inferior cranial nerves involvement: a case report

Petrositis, osteomyelitis of temporal bone, is a rare complication of middle ear infection or mastoiditis. Symptoms reported in patients with petrositis are otalgia, deep facial pain, headache, otorrhea, fever, coma and cranial nerve paralysis. Current diagnostic tests for this complication include high-resolution CT scan, brain MRI and bone scan with Technetium, Gallium and Indium 1-11. A 34 years old lady with left multiple cranial nerves palsies of VII, VIII, IX, X, XII is presented. She had a history of otitis media and then mastoiditis in left side 6 months ago which was underwent tympanomastoidectomy. In radiological studies there was involvement of parameninge tissue next to petrous bone. Gallium scan was highly suggestive for petrous osteomyelitis. She was treated with empiric parenteral antibiotics and her symptoms resolved completely

Study of clinical findings and neuroimaging aspects in Wilson disease

Introduction: Wilson disease or hepatolenticular degeneration is a genetic disorder with an autosomal recessive pattern of inheritance. It is due to an error of copper metabolism, the major presentations are changes in liver, central nervous system, eyes and occasionally other organs. Eary diagnosis is very important, because of its known treatment, in addition late diagnosis is associated with irreversible changes. Our purpose was study of clinical presentations and neuroimaging findingsof wilson disease

Material and Methods: This was a descriptive study in the neurology department Of Ghaem hospital since autumn 2000 to winter 2004. This study included patients with primary presentation of neurologic and psychiatric symptoms or who were diagnosed by case finding in family

Results: There were 23 cases and 15 of them were men.Chief complaints were: movement disorder, psychiatric disorders,speech disorder and slowing of movement in order. Seizure, amen-orrehea and esophagial varicose had high prevalance among our cases.Brain MRI disorders were seen in 95.3% of cases

Conclusion: The incidence of seizure and amenorrhea among our cases was more than previous studies. Because of high incidence of esophagial varicose in patients with primary symptoms of nervous system we recommend esophagoscopy for all patients should be done. This study showed there was no relationship between severity of symptoms and brain MRI disorders. MRI disorders may be seen in patients in presymptomatic stage. According to this we recommend brain MRI can be used as an ancillary diagnostic test