Third Cranial Nerve Palsy in Sphenoid Sinusitis
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229 |
Resumo: | Sphenoid sinus disease is particular not only for its clinical presentation, as well as their complications. Although rare, these may present as cranial nerve deficits, so it is important to have a high index of suspicion and be familiar with its diagnosis and management. Symptoms are often nonspecific, but the most common are headache, changes in visual acuity and diplopia due to dysfunction of one or more ocular motor nerves. The authors report a case of a 59 years-old male, who was referred to the ENT emergency department with frontal headaches for one week which had progressively worsened and were associated, since the last 12 hours, with diplopia caused by left third cranial nerve palsy. Neurologic examination was normal aside from the left third cranial nerve palsy. Anterior and posterior rhinoscopy excluded the presence of nasal masses and purulent rhinorrhea. The CT scan revealed a soft tissue component and erosion of the roof of the left sphenoid sinus. Patient was admitted for intravenous antibiotics and steroids treatment without any benefit after 48 hours. He was submitted to endoscopic sinus surgery with resolution of the symptoms 10 days after surgery. The authors present this case for its rarity focusing on the importance of differential diagnosis in patients with headaches and cranial nerves palsies.Keywords: Sphenoid Sinusitis; Oculomotor Nerve Diseases. |
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Third Cranial Nerve Palsy in Sphenoid SinusitisParésia do Nervo Motor Ocular Comum em Contexto de Sinusite EsfenoidalSphenoid sinus disease is particular not only for its clinical presentation, as well as their complications. Although rare, these may present as cranial nerve deficits, so it is important to have a high index of suspicion and be familiar with its diagnosis and management. Symptoms are often nonspecific, but the most common are headache, changes in visual acuity and diplopia due to dysfunction of one or more ocular motor nerves. The authors report a case of a 59 years-old male, who was referred to the ENT emergency department with frontal headaches for one week which had progressively worsened and were associated, since the last 12 hours, with diplopia caused by left third cranial nerve palsy. Neurologic examination was normal aside from the left third cranial nerve palsy. Anterior and posterior rhinoscopy excluded the presence of nasal masses and purulent rhinorrhea. The CT scan revealed a soft tissue component and erosion of the roof of the left sphenoid sinus. Patient was admitted for intravenous antibiotics and steroids treatment without any benefit after 48 hours. He was submitted to endoscopic sinus surgery with resolution of the symptoms 10 days after surgery. The authors present this case for its rarity focusing on the importance of differential diagnosis in patients with headaches and cranial nerves palsies.Keywords: Sphenoid Sinusitis; Oculomotor Nerve Diseases.A patologia do seio esfenoidal é particular não só na sua apresentação clínica, mas também pelas suas complicações. Apesar de raras estas podem apresentar-se como défices dos pares cranianos, sendo importante ter um elevado índice de suspeição e estar familiarizado com o seu diagnóstico e abordagem terapêutica. Os sintomas são por vezes muito inespecíficos, contudo os mais frequentes são as cefaleias, alterações da acuidade visual e diplopia no contexto de disfunção de um ou mais nervos oculares motores. Reporta-se o caso de um indivíduo do sexo masculino, 59 anos de idade, que foi referenciado ao Serviço de Urgência Otorrinolaringologia por quadro de cefaleias frontotemporais de carácter progressivo com uma semana de evolução e agravamento clínico nas últimas 12 horas associando-se diplopia. O exame neurológico sumário não releva outras alterações para além da parésia do nervo motor ocular comum esquerdo. Na rinoscopia anterior/posterior não se verificava presença de massas ou rinorreia mucopurulenta. A Tomografia Computadorizada revelava preenchimento por componente tecidual de partes moles dos seios esfenoidais e erosão do teto do seio esfenoidal esquerdo. Iniciou-se terapêutica endovenosa de largo espectro e corticoterapia sem melhoria clínica às 48 horas. Foi submetido a cirurgia endoscópica nassosinusal com boa resposta clínica e resolução completa da sintomatologia ao 10º dia pós-operatório. Os autores apresentam este caso pela sua raridade e pela sua importância no diagnóstico diferencial de doentes com cefaleias e parésia de pares cranianos.Palavras-chave: Sinusite Esfenoidal; Doenças do Nervo Oculomotor.Ordem dos Médicos2014-12-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfimage/jpegimage/jpegapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentimage/jpegimage/jpegimage/jpegimage/jpeghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229oai:ojs.www.actamedicaportuguesa.com:article/5229Acta Médica Portuguesa; Vol. 27 No. 6 (2014): November-December; 782-786Acta Médica Portuguesa; Vol. 27 N.º 6 (2014): Novembro-Dezembro; 782-7861646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/4167https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/7214https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/7215https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/7216https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/7217https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/7218https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/7219https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/7220https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/7348Dores, Luís AlmeidaSimão, Marco AlveirinhoMarques, Marta CanasDias, Óscarinfo:eu-repo/semantics/openAccess2022-12-20T11:04:15Zoai:ojs.www.actamedicaportuguesa.com:article/5229Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:03.075686Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Third Cranial Nerve Palsy in Sphenoid Sinusitis Parésia do Nervo Motor Ocular Comum em Contexto de Sinusite Esfenoidal |
title |
Third Cranial Nerve Palsy in Sphenoid Sinusitis |
spellingShingle |
Third Cranial Nerve Palsy in Sphenoid Sinusitis Dores, Luís Almeida |
title_short |
Third Cranial Nerve Palsy in Sphenoid Sinusitis |
title_full |
Third Cranial Nerve Palsy in Sphenoid Sinusitis |
title_fullStr |
Third Cranial Nerve Palsy in Sphenoid Sinusitis |
title_full_unstemmed |
Third Cranial Nerve Palsy in Sphenoid Sinusitis |
title_sort |
Third Cranial Nerve Palsy in Sphenoid Sinusitis |
author |
Dores, Luís Almeida |
author_facet |
Dores, Luís Almeida Simão, Marco Alveirinho Marques, Marta Canas Dias, Óscar |
author_role |
author |
author2 |
Simão, Marco Alveirinho Marques, Marta Canas Dias, Óscar |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Dores, Luís Almeida Simão, Marco Alveirinho Marques, Marta Canas Dias, Óscar |
description |
Sphenoid sinus disease is particular not only for its clinical presentation, as well as their complications. Although rare, these may present as cranial nerve deficits, so it is important to have a high index of suspicion and be familiar with its diagnosis and management. Symptoms are often nonspecific, but the most common are headache, changes in visual acuity and diplopia due to dysfunction of one or more ocular motor nerves. The authors report a case of a 59 years-old male, who was referred to the ENT emergency department with frontal headaches for one week which had progressively worsened and were associated, since the last 12 hours, with diplopia caused by left third cranial nerve palsy. Neurologic examination was normal aside from the left third cranial nerve palsy. Anterior and posterior rhinoscopy excluded the presence of nasal masses and purulent rhinorrhea. The CT scan revealed a soft tissue component and erosion of the roof of the left sphenoid sinus. Patient was admitted for intravenous antibiotics and steroids treatment without any benefit after 48 hours. He was submitted to endoscopic sinus surgery with resolution of the symptoms 10 days after surgery. The authors present this case for its rarity focusing on the importance of differential diagnosis in patients with headaches and cranial nerves palsies.Keywords: Sphenoid Sinusitis; Oculomotor Nerve Diseases. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-12-30 |
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info:eu-repo/semantics/article |
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article |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229 oai:ojs.www.actamedicaportuguesa.com:article/5229 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/4167 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/7214 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/7215 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/7216 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/7217 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/7218 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/7219 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/7220 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5229/7348 |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 27 No. 6 (2014): November-December; 782-786 Acta Médica Portuguesa; Vol. 27 N.º 6 (2014): Novembro-Dezembro; 782-786 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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