title: [Sixth, seventh and tenth cranial nerve palsies associated with pseudotumor cerebri in a 13-year-old boy].
abstract: We describe the case of a 13-year-old boy who presented to the emergency department with an acute onset paresis of the left abducens, facial and vagus nerves. Bilateral papilledema was seen on fundoscopy. Blood tests and brain magnetic resonance imaging and angiography showed no abnormalities. A lumbar puncture revealed an elevated intracranial pressure (575mmH2O) and clear cerebrospinal fluid. The diagnosis of pseudotumor cerebri (PTC) associated with multiple cranial nerve palsies was made. Treatment with acetazolamide was initiated, resulting in progressive improvement with no sequelae and no clinical recurrence over an 8-month follow-up period. PTC in children can present with a wide spectrum of neurological signs, especially cranial nerve palsies which are most likely related to a pressure-dependent stretching mechanism. In 2007, distinctive diagnostic criteria for pediatric PTC were established, including the presence of any cranial nerve palsy in the absence of an identifiable etiology.
authors.affiliation: Service d'ophtalmologie de l'Hôtel-Dieu de France, CHU de l'université Saint-Joseph, Alfred Naccache street, Achrafieh, Beyrouth, Liban. Electronic address: joelle.antoun@hotmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Antoun
authors.forename: H El
authors.initials: HE
authors.lastname: Rami
authors.forename: E
authors.initials: E
authors.lastname: Jabbour
authors.forename: E
authors.initials: E
authors.lastname: Chelala
mesh_terms: D000010:Abducens Nerve / Q000473:pathology; D020434:Abducens Nerve Diseases / Q000150:complications* / Q000175:diagnosis; D000293:Adolescent; D005154:Facial Nerve / Q000473:pathology; D005155:Facial Nerve Diseases / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D010211:Papilledema / Q000150:complications / Q000175:diagnosis; D011559:Pseudotumor Cerebri / Q000150:complications* / Q000175:diagnosis; D014630:Vagus Nerve / Q000473:pathology; D020421:Vagus Nerve Diseases / Q000150:complications* / Q000175:diagnosis
keywords: Abducens nerve palsy; Facial nerve palsy; Hypertension intracrânienne idiopathique; Idiopathic intracranial hypertension; Nerf abducens; Nerf vague; Paralysie faciale; Pseudotumor cerebri; Vagus nerve palsy