Multiple cranial nerve palsy

[dratrichatterjee]

A patient presented with headache and lower motor neuron palsy of facial nerve on right side. Fourteen days later, headache still continuing, the patient developed lower motor neuron palsy of right sided CN XI palsy, and bilateral XII CN palsy. DTR was found increased in all four limbs. Plantar was flexor and jaw jerk was non responsive.His blood examination revealed an isolated increase in ESR. Imaging showed CT scan, MRI t1, t2, FLAIR and MR Angiography all normal. Radiography of chest and sonography of abdomen was normal. The case was provisionally diagnosed as idiopathic polyneuritis cranialis, and the patient was started on methylprednisolone. The symptoms are not progressing anymore, but there is little recovery.

Awaiting opinion on this case....

[MG (Admin)]

Was an LP done?
What immune screening was done (ANA ANCA ESR CRP etc)?