Post‐irradiation neuromyotonia affecting trigeminal nerve distribution

Díaz, Juan Sánchez; Urban, E; Schiffman, Jade S.; Peterson, Andrew C.

doi:10.1212/wnl.42.5.1102

Cited by 31 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…palsy has been reported sporadically for cranial nerves, such as the optic nerve, 1 the trigeminal nerve, 2 the abducens nerve, 3 the vagus nerve, 4 and the hypoglossal nerve. 5 This palsy is even rarer in patients with nasopharyngeal carcinoma (NPC) who receive treatment with a conventional radiotherapy technique that delivers 180 -200 centigrays (cGy) per day.…”

mentioning

confidence: 99%

Radiation‐related cranial nerve palsy in patients with nasopharyngeal carcinoma

Lin

Jen

Lin

2002

Cancer

143

104

View full text Add to dashboard Cite

BACKGROUNDCranial nerve palsy is a rare complication after patients with nasopharyngeal carcinoma (NPC) receive radiotherapy using a technique that delivers 180–200 centigrays (cGy) per day. Cranial neuropathy is of particular clinical interest in terms of making a differential diagnosis, because it is also a common presenting manifestation in patients with NPC. Cranial neuropathy may lead to distressing signs and symptoms in these patients, and their treatment has not been addressed in previous reports. This article presents the authors' experience with radiotherapy‐related cranial nerve palsy in patients with NPC.METHODSNineteen patients were diagnosed with radiation‐related neuropathy. Patients with recurrent tumors or with a suspicion of persistent or recurrent tumors were excluded. Most patients were treated using 180 cGy or 200 cGy per fraction per day. The total dose was 7000–13,000 cGy to the nasopharynx and 5000–9000 cGy to the neck. Unilateral vocal cord paralysis alone and hearing loss were not included in the analysis.RESULTSThere were 15 male patients and 4 female patients. The latency before palsy occurred was 12–240 months. Single nerve palsy developed in four patients, including two patients with hypoglossal palsy and two patients with recurrent laryngeal palsy. Two patients had three nerve palsies each. The other 13 patients presented with 2 nerve palsies each. Vagus and hypoglossal palsy appeared to be a frequent combination and occurred in 11 patients. Overall, there were 17 patients with hypoglossal palsy (7 bilateral, 8 left‐sided, and 2 right‐sided), 11 patients with vagus palsy (2 bilateral, 7 left‐sided, and 2 right‐sided), 6 patients with recurrent laryngeal nerve palsy (5 bilateral), and 2 patients with accessory palsies (all bilateral). Marked neck fibrosis was present in 12 patients. Patients who had vocal cord paralysis suffered from easy choking and hoarseness. Severe respiratory difficulty occurred in two patients who had bilateral vocal cord palsy. Surgical procedures included laryngoplasty, tracheostomy, and gastrostomy. Quality of life improved considerably after patients underwent surgery.CONCLUSIONSRadiotherapy‐related cranial nerve palsy may occur in patients with NPC after they receive conventional radiotherapy. Hypoglossal nerve palsy was found the most frequently in this series, followed by vagus nerve palsy and recurrent laryngeal nerve palsy. Neck fibrosis and the course of the three nerves through the neck may be important risk factors for the development of palsy. The diagnosis must be made only after the possibilities of tumor‐induced palsy and idiopathic palsy are excluded. Surgery is helpful in improving the quality of life in many patients. Cancer 2002;95:404–9. © 2002 American Cancer Society.DOI 10.1002/cncr.10668

show abstract

mentioning

confidence: 99%

Radiation‐related cranial nerve palsy in patients with nasopharyngeal carcinoma

Lin

Jen

Lin

2002

Cancer

143

104

View full text Add to dashboard Cite

show abstract

“…12 Additional reports have described radiation-induced cranial neuropathies involving nerves I, II, V, VI, VIII, X, XI, and XII, with hypoglossal neuropathy again being the most often reported. 3,6,7,17,19 Myokymia is seen clinically as a rippling or undulating movement under the skin that may often be mistaken for fasciculations. Electromyographic evaluation reveals that myokymic discharges represent grouped, rhythmic discharges of single motor units.…”

Section: Discussionmentioning

confidence: 99%

Delayed radiation-induced bulbar palsy mimicking ALS

Glenn

Ross

2000

Muscle Nerve

View full text Add to dashboard Cite

“…1,7,27 The majority of these cases are associated with nerve damage following radiation. We were able to find two previous reports of CMUA occurring in laryngeal muscles.…”

Section: Discussionmentioning

confidence: 99%

Conduction block and continuous motor unit activity in chronic acquired demyelinating polyneuropathy

Meriggioli

Sanders

1999

Muscle Nerve

View full text Add to dashboard Cite

The term continuous motor unit activity (CMUA) may be used to refer to the involuntary, sustained activity of motor units caused by hyperactivity of peripheral motor nerves CMUA has been reported in association with acquired neuropathies such as chronic inflammatory demyelinating polyneuropathy. The precise mechanism responsible for the excess muscle activity is not defined, but the activity is believed to originate in the peripheral nerves, perhaps at sites of focal demyelination. We describe a case of an acquired, demyelinating neuropathy associated with distal motor conduction block in which CMUA was observed in muscles innervated by blocked axons. Despite the prolonged disease duration of nearly 40 years, marked clinical and electrophysiological improvement as well as resolution of the CMUA were observed following immunosuppressive therapy. A relationship between the chronic motor conduction block and the excess muscle activity is postulated. © 1999 John Wiley & Sons, Inc. Muscle Nerve 22: 532–537, 1999.

show abstract

Post‐irradiation neuromyotonia affecting trigeminal nerve distribution

Cited by 31 publications

References 0 publications

Radiation‐related cranial nerve palsy in patients with nasopharyngeal carcinoma

Radiation‐related cranial nerve palsy in patients with nasopharyngeal carcinoma

Delayed radiation-induced bulbar palsy mimicking ALS

Conduction block and continuous motor unit activity in chronic acquired demyelinating polyneuropathy

Contact Info

Product

Resources

About