Multiple cranial palsy in pasein with cerebral cavernoma malformations on the brain stem

Abstract

Facial palsy is a condition that is often encountered in neurological practice. The weakness of closing the eyes can be found in cases of central facial paralysis. Facial palsy is characterized by acute, unilateral, partial, or complete facial paralysis. Cerebral cavernous malformation is one rare form of lesion, accounting for about 5 to 13% of blood vessel anomalies in the central nervous system. Brain stem cavernomas are rare and less than 20% intracerebral cavernomas. Most patients with cerebral cavernoma of the brain stem have symptoms of acute neurological deficits. The inferior cerebellar pedunkel, vestibular nucleus, trigeminal nucleus of the spine, and ambiguous nucleus are usually affected. Clinical signs include vestibulocerebellar symptoms such as vertigo, falling to the side of lesions, diplopia, multidirectional nystagmus, ipsilateral Horner syndrome, hiccups, contralateral body weakness, pain and sensation of temperature, motion, dysphonia, dysphagia, dysarthria, and decreased gag reflex (Sciacca et al., 2019). A 26-year-old man with a right eye cannot close, the right face cannot be moved since 4 months, the right side face feels thick from the right cheek to the right chin. The patient has no previous history of stroke. In the examination obtained hipestesi NV2 and NV3 right, facial palsy peripheral right.