13. Neurofibromatosis two presenting with bilateral sixth and seventh nerve palsies

Article type: Pictures in Neurology
Article title: Neurofibromatosis two presenting with bilateral sixth and seventh nerve palsies

Journal: Neurology and Clinical Neuroscience
Year: 2019
Authors: Jamir Pitton Rissardo, Ana Letícia Fornari Caprara
E-mail: jamirrissardo@gmail.com

ABSTRACT
A 25-year-old female was admitted with weakness of facial muscles and binocular horizontal diplopia within 3h of onset. She was previously healthy and her family history was remarkable for brain tumors. The neurological examination showed the weakness of bilateral upper and lower facial muscles associated with bilateral lateral rectus muscle palsy. Laboratory tests were within normal limits. A noncontrast cranial computed tomography (CT) scan was suggestive of tumors in the posterior cranial fossa; a contrast CT scan revealed the lesions. Prednisone 60 mg/day was started. Upon further questioning, the patient reported that on the maternal side of the family, there were three relatives, including her mother, who had a diagnosis of neurofibromatosis 2 (NF2). On the seventh admission day, she was referred to the neurosurgical service of another city.
Keywords: Abducens nerve, facial nerve, neurofibromatosis, neurofibromatosis 2, paralysis

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DOI

Citation
Rissardo JP, Caprara AL. Neurofibromatosis two presenting with bilateral sixth and seventh nerve palsies. Neurol Clin Neurosci 2019;7:47

Figure 1. Neuroimages showing bilateral lesion with extension into the meatus, heterogeneous contrast enhancement, and obliteration of the respective pontocerebellar angles associated with brainstem compression in the posterior cranial fossa (indicated by the arrow). In addition, adjacent bone remodeling with smooth corticated edges can be observed. Axial(A), sagittal(B), and coronal(C) views of contrast CT.