Open AccessA Unique Constellation of Multiple Cranial Neuropathies in a Patient with Preeclampsia
Author(s) -
Pardis Zarifkar,
Klaus Hansen,
C Crone,
Kirsten Svenstrup,
Vibeke Andreé Larsen,
William Kristian Karlsson
Publication year - 2022
Publication title -
case reports in neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.207
H-Index - 15
ISSN - 1662-680X
DOI - 10.1159/000524459
Subject(s) - medicine , tongue , cranial nerves , preeclampsia , dysphagia , denervation , hypoglossal nerve , palsy , surgery , anatomy , pregnancy , pathology , alternative medicine , biology , genetics
A 36-year-old nullipara at 35 weeks of gestation woke up with slurred speech and dysphagia. The next day, she developed abruption of the placenta, underwent an acute cesarean, and was diagnosed with severe preeclampsia. Neurologic examination revealed flaccid dysarthria, bilateral soft palate palsy, reduced taste of the left posterior tongue, left-sided tongue deviation, and paralysis of the left sternocleidomastoid and trapezius muscles. MRI revealed left-sided tongue edema compatible with acute left hypoglossal nerve denervation and electromyography of the left trapezius and glossal muscles showed profuse denervation potentials. In conclusion, multiple cranial neuropathies may occur in and even be a presenting symptom of preeclampsia. In this study, we report the first case of multiple cranial neuropathies involving cranial nerves IX, X, XI, and XII in a patient with preeclampsia. Possible pathogenic mechanisms of cranial neuropathy in preeclampsia include immune-mediated neuropathy with or without demyelination, microvascular thromboses, and perineural edema.