RESUMEN
Ramsay-Hunt syndrome (RHS) is a well known disease caused by varicella-zoster virus infection in the geniculate ganglion of the facial nerve. Although the otic vesicle and facial palsy are easily recognized clinical signs of RHS, cases of associated multiple cranial nerve palsies present a difficult diagnostic challenge and furthermore, the mechanisms is unclear. We report a case of an 86-year-old man with otic crusted vesicles and peripheral typed facial palsy preceded by severe headache and fever. Several days later, he developed diplopia, dysphagia, hiccup and abdominal myoclonus. On fluid attenuated inversion recovery image of brain, diffuse subdural inflammatory exudates, which disappeared after treatment of acyclovir and corticosteroid, and ipsilateral facial nerve enhancement were observed in follow-up imaging.
Asunto(s)
Anciano de 80 o más Años , Humanos , Aciclovir , Encéfalo , Enfermedades de los Nervios Craneales , Nervios Craneales , Trastornos de Deglución , Diplopía , Exudados y Transudados , Nervio Facial , Parálisis Facial , Fiebre , Estudios de Seguimiento , Ganglio Geniculado , Cefalea , Herpesvirus Humano 3 , Hipo , MiocloníaRESUMEN
Primary frontal sinus lymphoma is a very uncommon disease. In all the previously reported cases, the presenting symptoms have been due to the tumor mass effect. We present an unusual case report of an immunocompetent patient who presented with facial palsy, and then progressively developed other cranial nerve palsies over several months. He was later diagnosed with diffuse large B cell lymphoma originating from the frontal sinus. The patient underwent chemotherapy, but eventually had to receive autologous peripheral blood stem cell transplantation. He is currently disease-free. The clinical course, diagnostic workup, and therapeutic outcome are described.