多発脳神経麻痺を呈した症例の病因および臨床的特徴について(神経内科学教室竹宮敏子教授退任記念特別号)

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  • Etiology and Clinical Features of Patients Presenting Multiple Cranial Neuropathy(Special Issue in Hornor of the Retirement of Professor Toshiko Takemiya at the Department of Neurology, Tokyo Women's Medical University)

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神経内科学教室竹宮敏子教授退任記念特別号

Multiple cranial neuropathy was observed in various diseases, and sometimes the etiology was unknown. In this paper, we examined the etiology and clinical features of 126 patients with multiple cranial neuropathy admitted to our department from January in 1978 to October in 1995. There were 16 cases of acute inflammatory demyelinating polyradiculoneuropathy, 4 chronic inflammatory polyradiculoneuropathy, 16 Fisher syndrome, 33 tumors (18 primary tumors, 9 metastatic tumors, 7 nasopharyngeal tumors), 8 Tolosa-Hunt syndrome, 4 cavernous sinus syndrome, 8 encephalitis meningitis, 7 patients with a viral infection which overlapped encephalitis meningitis, 6 vasculitis, 3 sarcoidosis, 2 Collet-Sicard syndrome, 1 Vernet syndrome, 1 Villaret syndrome, 15 idiopathic multiple cranial neuropathy patients which overlapped syndrome with cranial neuritis and 9 were others; 3 neurosyphilis, 3 aneurysm, 1 brain abscess, 1 Arnold-Chiari malformation and 1 diabetic neuropathy. The cranial nerves most frequently involved were the third, sixth and seventh. Most high-frequency diseases are inflammatory demyelinating polyradiculoneuropathy and tumors. Ten patients had multiple cranial neuropathy followed by a respiratory infection, and 3 of those cases were suspected vasculitis or circulatory insufficient. In many cases, the cerebrospinal fluid was an abnormal protein elevation. Therapy with prednisone was effective.

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