Eye twist and tongue twist: a rare neurological syndrome.
A 27-year-old man presented with diplopia without features of raised intracranial pressure. He had left sixth cranial nerve (CN) palsy. Initial investigations in the form of blood tests, cerebrospinal fluid (CSF) opening pressure including CSF analysis and CT head were normal. He represented with paraparesis after 3 weeks. Examination revealed sixth CN palsy (eye twist) and new left-sided twelfth CN palsy (tongue twist), and hence Godtfredsen syndrome was diagnosed. MRI showed vertebral and clivus metastases. He showed partial response to high dose steroid. The statement 'sixth CN palsy may be a false localising sign' in neurology, should be followed by '....it can also be a true initial sign of clivus mass.'
Department of Neurology, College of Medical Sciences-Teaching Hospital, Bharatpur, Nepal. kushrajt@yahoo.co.in
Lekhjung
L
Thapa
Raju
R
Paudel
Pramod
P
Chhetri
P V S
PV
Rana
D020434:Abducens Nerve Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D000328:Adult; D003388:Cranial Fossa, Posterior / Q000503:physiopathology; D003937:Diagnosis, Differential; D004172:Diplopia / Q000503:physiopathology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D014059:Tongue / Q000503:physiopathology
D005938:Glucocorticoids