Acute Unilateral Isolated Oculomotor Nerve Palsy in an Adult Patient with Influenza A

Senda, Joe; Araki, Kunihiko; Tachi, Yasushi; Watanabe, H.; Kagawashira, Yuichi; Ito, Mizuki; Atsuta, Naoki; Katsuno, Masahisa; Watanabe, Haruo; Sobue, Gen

doi:10.2169/internalmedicine.0850-18

Cited by 6 publications

(4 citation statements)

References 24 publications

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“…Influenza infections can cause several neurological complications such as polyneuritis, meningitis, encephalomyelitis, encephalopathy, GBS, and cranial nerve involvement (oculomotor nerve involvement). 3,4 They can also cause different muscle involvements. Bilateral upper extremity weakness, and bilateral hand weakness due to myositis, and bilateral femoral nerve compression due to rhabdomyolysis have been reported.…”

Section: Discussionmentioning

confidence: 99%

Influenza A (H1N1) Encephalitis with Right Axillary Nerve Lesion

Atalay¹,

Özel²

2023

J PMR Sci

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ABS TRACTThe influenza virus (H1N1) infection can be causative of the encephalitis, as with other influenza virus infections. In a six-year-old female patient, fever, and neurological symptoms developed three days after influenza-like symptoms appeared. Multifocal lesions, including bilateral thalamus, brain stem, and cerebral hemisphere, compatible with viral encephalitis were monitored on cranial magnetic resonance imaging of the patient. A result of physical therapy and rehabilitation program, her neurological symptoms except for abduction and external rotation of the right shoulder improved. Right axillary nerve lesion was detected on electromyoneurographic. The patient was considered to have axillary nerve involvement due to the same infection in addition to H1N1 encephalitis. Influenza A H1N1 virus can appear with various neurological medical courses. It should be kept in mind with the help of this case report that central and peripheral nervous system can be involved together such as deterioration of general condition and change in consciousness.

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Section: Discussionmentioning

confidence: 99%

Influenza A (H1N1) Encephalitis with Right Axillary Nerve Lesion

Atalay¹,

Özel²

2023

J PMR Sci

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“… 6 However, as previously mentioned, COVID-19 is known to have a variety of neurological manifestations, and focal cranial nerve involvement has been reported in other viral illnesses (eg, influenza A). 7 Ultimately, we do not yet have enough information about this condition to be able to definitively say which will have caused the focal cranial nerve manifestations.…”

Section: Discussionmentioning

confidence: 99%

Bacterial meningitis and COVID-19: a complex patient journey

2021

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A woman in her 70s presented to the emergency department with fever, fluctuating cognition and headache. A detailed examination revealed neurological weakness to the lower limbs with atonia and areflexia, leading to a diagnosis of bacterial meningitis, alongside a concurrent COVID-19 infection. The patient required critical care escalation for respiratory support. After stepdown to a rehabilitation ward, she had difficulties communicating due to new aphonia, hearing loss and left third nerve palsy. The team used written communication with the patient, and with this the patient was able to signal neurological deterioration. Another neurological examination noted a different pattern of weakness to the lower limbs, along with new urinary retention, and spinal arachnoiditis was identified. After more than 10 weeks in the hospital, the patient was discharged. Throughout this case, there were multiple handovers between teams and specialties, all of which were underpinned by good communication and examination to achieve the best care.

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“…Our previous case report described influenza A infection causing acute isolated unilateral oculomotor nerve palsy presenting as focal intracranial nerve inflammation with ophthalmoparesis and spontaneous recovery (9). These disorders were previously able to be diagnosed through intra-orbital MRI with appropriate sequences and immunological assays to detect the presence of antiganglioside antibodies (10).…”

Section: Discussionmentioning

confidence: 99%

Acute Bilateral Oculomotor Nerve Palsy in an Adult Patient with <i>Neisseria meningitidis</i>

et al. 2019

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A 69-year-old woman was admitted to our hospital with a fever, dizziness, and headache caused by Neisseria meningitidis . After ceftriaxone was administered, she suddenly developed bilateral oculomotor nerve palsy. Intra-orbital magnetic resonance imaging using appropriate sequences revealed that her bilateral third intracranial nerves were enlarged and enhanced. She achieved complete recovery by two months after additional short-term treatment with intravenous immunoglobulin and methylprednisolone. Although intracranial nerve disorders that result from bacterial meningitis are most frequently reported in children, it is noteworthy that it can also cause focal intracranial nerve inflammation with ophthalmoparesis in N. meningitidis infection in adults.

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Acute Unilateral Isolated Oculomotor Nerve Palsy in an Adult Patient with Influenza A

Cited by 6 publications

References 24 publications

Influenza A (H1N1) Encephalitis with Right Axillary Nerve Lesion

Influenza A (H1N1) Encephalitis with Right Axillary Nerve Lesion

Bacterial meningitis and COVID-19: a complex patient journey

Acute Bilateral Oculomotor Nerve Palsy in an Adult Patient with <i>Neisseria meningitidis</i>

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