Congenital Peripheral Facial Palsy Associated with Cerebellopontine Angle Arachnoid Cyst

Erman, Tahsin; Demırhındı, Hakan; Göçer, A. İskender; Akgül, Erol; İldan, Faruk; Boyar, Bülent

doi:10.1159/000083743

Cited by 9 publications

(6 citation statements)

References 40 publications

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“…But FLAIR may assist in the differentiation of the type of the cyst due to the different signal according to the contents. IACs which contain CSF have significantly suppressed signals, whereas epidermoid cysts are filled with protein and keratin, and display higher signals than CSF on FLAIR images based on the results previously described [8,9,20,25,27].…”

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confidence: 62%

“…Intracranial cysts are likely developmental in origin and can develop in cerebrum, cerebellum, and brainstem thus may cause cranial nerve dysfunction in human and dogs as well [5,21,29,31]. However, intracranial cysts located in the brainstem are extremely rare in both human and dogs [8,18,21,23,28,31,32]. We described a case of unilateral facial paresis concurrent with lacrimal loss, which was strongly suspected to be caused by a pontomedullary cystic lesion.…”

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confidence: 95%

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Unilateral Facial Paresis Secondary to a Suspected Brainstem Arachnoid Cyst in a Maltese Dog

Kim

Jung

Kang

et al. 2011

The Journal of Veterinary Medical Science

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ABSTRACT. An 8-year-old, intact female Maltese dog was presented with decreased tear production and unilateral loss of eye blinking. Neuro-ophthalmic examination and brain magnetic resonance imaging were performed to determine the origin of facial paresis. A cystic lesion in the left pontomedullary region which displayed equal intensity to cerebrospinal fluid was revealed. Hyposignality was noted on fluid attenuated inversion recovery sequences, and the lesion was suggestive of an arachnoid cyst. This report described unilateral facial nerve dysfunction that resulted from a suspected brainstem arachnoid cyst in an unusual anatomic location.KEY WORDS: arachnoid cysts, brainstem, canine, facial paresis.J. Vet. Med. Sci. 73(4): 459-462, 2011 Facial paresis and paralysis result in facial muscle dysfunction from cranial nerve diseases and injuries [26]. Intracranial and brainstem abnormalities including congenital and neoplastic space-occupying lesions can result in facial nerve dysfunction, which are classified as central in origin. Additionally, parasympathetic denervation to the lacrimal pathway of the facial nerve can also result in loss of tear production. Intracranial cysts are likely developmental in origin and can develop in cerebrum, cerebellum, and brainstem thus may cause cranial nerve dysfunction in human and dogs as well [5,21,29,31]. However, intracranial cysts located in the brainstem are extremely rare in both human and dogs [8,18,21,23,28,31,32]. We described a case of unilateral facial paresis concurrent with lacrimal loss, which was strongly suspected to be caused by a pontomedullary cystic lesion.An 8-year-old, intact female Maltese dog was admitted for evaluation of a unilateral blinking disorder. The patient had been diagnosed as keratoconjunctivitis sicca (KCS) by the referring animal hospital. Topical therapy for KCS including artificial tear, topical antibiotics and cyclosporine showed no improvement. Moreover, sudden onset of blepharoplegia of the left eye (OS) was detected a few days before visiting our referral hospital.The outer appearance of the face was symmetrical. However, the left nostril was drier and more narrowed than the right nostril (Fig. 1A). Marked blepharoedema and mild mucoid ocular discharge were observed bilaterally ( . A neuro-ophthalmic examination revealed a loss of palpebral and corneal reflexes (OS) and the menace response (OS). Direct and consensual pupillary light responses (PLR) and the results of other bilateral cranial nerve tests were normal. The patient was tentatively diagnosed as unilateral facial paresis. As the course of clinical signs was slow and progressive, the presence of primary cause of facial paresis was strongly suspected rather than idiopathic facial paresis which typically showed acute onset. Thus laboratory tests were performed to search the cause of KSC and facial paresis. Otoscopic examination and skull radiography showed no evidence of otitis. The results of routine laboratory test were not remarkable. Reverse transcriptase-polymerase cha...

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confidence: 62%

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confidence: 95%

Unilateral Facial Paresis Secondary to a Suspected Brainstem Arachnoid Cyst in a Maltese Dog

Kim

Jung

Kang

et al. 2011

The Journal of Veterinary Medical Science

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“…Most arachnoid cysts become symptomatic in early childhood; 60-90% of patients are children. 1,2,4 The CPA represents the second most common location for arachnoid cysts, accounting for approximately 10%. 2 Bilaterality and multiplicity are not common features of CPA arachnoid cysts.…”

Section: Discussionmentioning

confidence: 99%

“…Cerebellar dysfunction is the second symptom and only a few patients with CPA arachnoid cysts with facial palsy are reported in the literature. [3][4][5] In a series of posterior fossa arachnoid cysts, one patient presented with facial paresis who had an acoustic neuroma associated with the cyst. 2 In our patient, the peripheral facial palsy was not congenital and was related to direct compression of the facial nerve, confirmed during surgery.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Only a few cases of CPA arachnoid cysts with peripheral facial palsy have been reported in the literature. [3][4][5] The central-peripheral transitional region of the eighth cranial nerve is the most susceptile region for gliosis and it is not rare. 6 Acoustic neuroma can be associated with a CPA arachnoid cyst, 2 but gliosis is also frequently found within the eighth nerve in patients with acoustic schwannoma.…”

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confidence: 99%

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