Presentation
Left third, seventh and eighth cranial nerve palsies.
Patient Data
Age: 70 years
Gender: Female
From the case:
Multiple cranial nerve thickening and enhancement
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Axial T2
Thickening and enhancement of the left 7th, 8th nerves and both 9th nerves.
Small artery disease with bilateral chronic ischemic changes.
Brain atrophic changes.
From the case:
Multiple cranial nerve thickening and enhancement
Thickening and enhancement of the left 7th, 8th nerves and both 9th nerves.
Case Discussion
The patient is known to have leukemia under treatment.
Multiple cranial nerve thickening and enhancement has a long list of differentials:
- infection: e.g. tuberculosis, Lyme disease
- granulomatous disease: e.g. sarcoidosis
- demyelination: multiple sclerosis (MS)
- Guillain–Barré syndrome
- chronic inflammatory demyelinating polyneuropathy (CIDP)
- neoplastic:
- primary
- secondary
- CSF seeding
- infiltration by lymphoma / leukemia / multiple myeloma
This case is courtesy of Dr. Aida Yosif, Assistant Lecturer of Radiodiagnosis, National Cancer Institute.