Neuritis ossificans of a cranial nerve

Abstract

The authors report the case of intracranial neuritis ossificans presenting as chronic accessory neuropathy. Neuritis ossificans is a rare reactive nerve disease that has been reported to affect systemic peripheral nerves. To the best of the authors' knowledge, this is the first documented case of neuritis ossificans observed in a cranial nerve. The lesion was revealed on imaging studies and appeared, intraoperatively, as a nonsessile intradural lesion with significant calcification of rootlets of the lower cranial nerves. Microscopically, the lesion featured zonal heterotopic calcification typical of neuritis ossificans. Although it is a rare entity, neuritis ossificans can be considered in the differential diagnosis of lower cranial nerve neuropathy.

Sonographic diagnosis of neuritis ossificans of the median nerve

“…Neuritis ossificans, which is the heterotopic ossification in a peripheral nerve, is an extremely rare condition, and few cases have been reported in the literature . Previously reported sites include the ulnar, median, saphenous, tibial, sciatic, digital, common peroneal, cranial, lateral sural cutaneous, and radial nerves …”

Neuritis Ossificans of the Radial Nerve

“…The current case emphasizes neuritis ossificans as a rare but potentially underacknowledged cause of mononeuropathy in the literature. [2][3][4][5][6][7][8][9][10] Reported sites included the saphenous and tibial nerves, 2 median nerve ossification in a tennis player, 3 and the sciatic nerve. 4,5 Additional idiopathic cases include ulnar neuropathy at the elbow, 7 cranial nerve neuritis ossificans, 8 and common peroneal nerve involvement.…”

“…[2][3][4][5][6][7][8][9][10] Reported sites included the saphenous and tibial nerves, 2 median nerve ossification in a tennis player, 3 and the sciatic nerve. 4,5 Additional idiopathic cases include ulnar neuropathy at the elbow, 7 cranial nerve neuritis ossificans, 8 and common peroneal nerve involvement. 9,10 Other reported sites of neuropathy due to heterotrophic ossification and the potential predisposing factors include sciatic neuropathy after hip fracture and fixation, 11 biceps femoris muscle strain from weight lifting 12 , and ulnar neuropathy after elbow burns.…”

“…Mononeuropathy is a rare cause of neuritis ossificans, and the management is mostly surgical, with common residual nerve injury. [2][3][4][5][6][7][8][9][10] To our knowledge, this is the first case of neuritis ossificans of the radial nerve excised with no residual neurological deficits.…”