The first clinical case of carpal tunnel syndrome (CTS) in Cuban HIV-infected patient was described, and the scientific literature indexed in: PUBMED/MEDLINE, LILACS and BIREME were revised. The case presented was a male with HIV infection without preceding opportunistic illnesses, CD4+ T cell count over 200 cells/mm3 and clinical symptoms of pain, tingling and numbness in the right hand and wrist for three months. The electrophysiological study was compatible with CTS. The pharmacological treatment did not modify the symptoms and the patient received specific surgical treatment with absolute resolution of symptoms. CTS is a compressive neuropathy that can occur in HIV-positive individuals with as similar frequency as in the general population. The association between HIV infection and CTS is scarcely described in the medical scientific literature and probably does not represent a different phenomenon from what happens in the HIV-negative population. Nevertheless, its clinical recognition among other neurological and muscle-skeletal manifestations in HIV-infected patients is important.
Cranial nerve palsies are commonly known comorbidities associated with nasopharyngeal carcinoma, occurring in nearly 20% of cases. These palsies occur in isolation or in common groupings, depending on the anterior or posterior cranial vault extension of the lesion. Cranial nerve VII palsy is relatively rare, with an incidence of less than 1%. As a poor marker of prognosis, cranial nerve involvement may lead to significant morbidity amongst patients with nasopharyngeal carcinoma.
We report a case of a 73-year-old male diagnosed with nasopharyngeal carcinoma with extension into the skull base who presented with both anterior and posterior cranial nerve involvement throughout the course of his disease. With lesions in cranial nerves III, V, VI, VII, IX, and XII, this patient experienced a sequence of right-sided facial paralysis, facial pain, inability to abduct his right eye, rightward tongue deviation, tinnitus, hearing loss, decreased extraocular eye movement superiorly, and dysphagia which subsequently worsened with chemotherapy and radiation. Most notably, he presented with a right-sided cranial nerve VII palsy, not commonly reported in the literature.
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